SAVREMENI PRISTUP PREVENCIJI GESTACIJSKOG DIJABETESA: MEDIKAMENTOZNA TERAPIJA I DIJETETSKI SUPLEMENTI – PREGLED LITERATURE
Sažetak
Uvod/Cilj: Gestacijski dijabetes melitus (GDM) predstavlja jednu od najčešćih komplikacija trudnoće i značajan javnozdravstveni problem, sa rastućom učestalošću usled porasta gojaznosti i insulinske rezistencije. Cilj ovog rada bio je da se analizira dostupna literatura o preventivnim strategijama za GDM, uključujući promene životnog stila, suplemente i farmakološke intervencije.
Materijal i metode: Sproveden je pregled literature pretraživanjem baza MEDLINE, Scopus i PubMed za period od 2000. do 2025. godine. Uključene su recenzirane studije koje su ispitivale preventivne mere za GDM, dok su isključene studije koje su se bavile isključivo terapijom već dijagnostikovanog GDM, kao i animalne studije, radovi nedostupni in extenso, kao i radovi koji nisu na engleskom jeziku. Selekciju su nezavisno sprovela dva autora, a u spornim slučajevima postignut je konsenzus svih autora.
Rezultati: Povišen indeks telesne mase pre trudnoće i tokom trudnoće predstavlja najvažniji modifikabilni faktor rizika za razvoj GDM. Najefikasnija preventivna strategija uključuje održavanje normalne telesne mase, pravilnu ishranu i redovnu fizičku aktivnost, pri čemu fizička aktivnost pokazuje najizraženiji efekat. Od suplemenata, mio-inozitol pokazuje potencijal u smanjenju incidencije GDM i poboljšanju glikoregulacije, dok su rezultati za vitamin D, probiotike i omega-3 masne kiseline nekonzistentni. Metformin može smanjiti rizik od GDM kod visokorizičnih trudnica, naročito kod žena sa sindromom policističnih jajnika, ali rezultati studija ostaju kontradiktorni, uz otvorena pitanja o dugoročnim efektima na potomstvo.
Zaključak: Promene životnog stila i higijensko-dijetetski režim ostaju osnova prevencije GDM. Medikamentozna terapija i dijetetski suplementi mogu imati izvesnu ulogu u visokorizičnim grupama, mada nema dovoljno dokaza za njihovu rutinsku primenu. Potrebna su dalja istraživanja radi definisanja optimalnih preventivnih pristupa.
Reference
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