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Introducción. La diabetes mellitus tipo 2 y la obesidad son enfermedades con alta prevalencia, gran morbi-mortalidad y elevados costos en salud. La cirugía bariátrica ha demostrado efectividad para inducir pérdida de peso y un control adecuado de la glicemia. Métodos. Estudio observacional analítico retrospectivo, realizado entre 2014 y 2019 en una institución de alta complejidad. Se incluyeron pacientes prediabéticos y diabéticos sometidos a cirugía bariátrica tipo baipás gástrico en Y-de-Roux o manga gástrica. Se analizaron la mejoría o resolución de la diabetes y la pérdida del exceso de peso a los 6, 12, 24 y 36 meses luego de la cirugía. Resultados. Se incluyeron 103 pacientes en el estudio, 45 pacientes diabéticos y 58 pacientes prediabéticos. La única variable perioperatoria con diferencia estadísticamente significativa fue el tiempo quirúrgico mayor en el baipás (70 vs. 47,5 minutos; p<0,001). La pérdida de exceso de peso fue mayor en el baipás. Los pacientes diabéticos sometidos a baipás tuvieron un mayor porcentaje de resolución o control comparados con los sometidos a manga gástrica. En los pacientes prediabéticos hubo resolución en ambos grupos luego de 24 meses de seguimiento. Conclusión. El baipás gástrico y la manga gástrica presentan excelentes resultados en cuanto a pérdida de peso y control metabólico en pacientes con diabetes mellitus tipo 2 y prediabetes, pero en nuestros pacientes se lograron resultados superiores en ambos aspectos con el baipás gástrico

Introduction. Type 2 diabetes mellitus and obesity are diseases with high prevalence, high morbidity and mortality and high health costs. Bariatric surgery has proven effective in inducing weight loss and adequate glycemic control. Methods. Retrospective analytical observational study conducted between 2014 and 2019 in a high-complex institution. Prediabetic and diabetic patients undergoing Roux-en-Y gastric bypass or gastric sleeve were included; analyzing the improvement or resolution of diabetes and the loss of excess weight at 6, 12, 24 and 36 months after surgery. Results. One-hundred and three patients were included in the study, 45 diabetic patients and 58 pre-diabetic patients. The only perioperative variable with a statistically significant difference was the longer surgical time in the bypass (70 vs. 47.5 min; p<0.001). Loss of excess weight was always greater in bypass. Diabetic patients who underwent bypass had a higher percentage of resolution or control compared to those who underwent the sleeve procedure. In pre-diabetic patients, there was 100% resolution in both groups after 24 months of follow-up. Conclusion. Gastric bypass and gastric sleeve present excellent results in terms of weight loss and metabolic control in patients with type 2 diabetes mellitus and pre-diabetes, but superior results in both aspects were achieved with the first technique in our patients

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OBJECTIVE: We assessed maternal and perinatal outcomes in pregnant women with type 1 diabetes, treated with continuous subcutaneous insulin infusion and real time continuous glucose monitoring. METHODS: This is a retrospective study, analyzing the basal characteristics, glycemic control, maternal and perinatal outcomes of pregnant women with type 1 diabetes, who were on an insulin pump with continuous glucose monitoring between 2011 and 2015. RESULTS: Fourteen patients were included. The median age was 33 and disease duration 12 years. Indications for therapy were mainly poor glycemic control and severe hypoglycemia. The median A1c decrease was 1.02% between the first and third trimester. Pregnancies were associated with complications: 7.1% of the patients had diabetic ketoacidosis, 7.1% had an abortion, 28.5% gestational hypertension and 12.2% preeclampsia. The median gestational age at birth was 37 weeks and four days; the frequency of preterm birth was 7.1% and macrosomia 21.4%. There were no congenital malformations or perinatal death. CONCLUSIONS: Baseline characteristics and results of patients in this study were similar to those reported in the previous literature. Continuous subcutaneous insulin infusion with continuous glucose monitoring is an alternative treatment option for pregnant women with type 1 diabetes before or during pregnancy.

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Objetivo: analizar la sensibilidad y especificidad de la relación proteína / creatinina en orina como método de detección de proteinuria en mujeres con sospecha de preeclampsia, teniendo en cuenta como estándar de oro la proteinuria en 24 horas. Materiales y métodos: en un estudio de corte transversal se incluyeron mujeres con embarazo mayor a 20 semanas, hospitalizadas en la Clínica Universitaria Bolivariana de Medellín por sospecha de preeclampsia. Se excluyeron gestantes con infección urinaria al momento del estudio, antecedentes de patologías crónicas que pudieran causar proteinuria y aquellas que no completaron la recolección de la muestra. A todas las pacientes se les realizó una medición de la relación proteína / creatinina en orina ocasional y la proteinuria en 24 horas. Se evaluó la correlación entre estas dos pruebas y el punto de corte de la relación proteína / creatinina con mejor rendimiento para la detección de proteinuria significativa. Resultados: se incluyeron 200 muestras de orina, encontrando proteinuria significativa en un 27 % del total de las muestras. La relación proteína / creatinina en orina ocasional mostró una alta correlación con la proteinuria de 24 horas (r = 0,775; p < 0,01). El punto de corte con mejor rendimiento para la detección de proteinuria significativa fue 0,30 mg/ mg, con una sensibilidad de 83 %, especificidad de 98 %, LR positivo de 60 y LR negativo de 0,17. Conclusión: la relación proteína / creatinina en orina ocasional puede ser usada como un método rápido, alternativo, para la determinación de proteinuria en pacientes con sospecha de preeclampsia.

Objective: To analyse the sensitivity and specificity of the protein/creatinine ratio in the urine as a method for detecting proteinuria in women with suspected preeclampsia, considering 24-hour proteinuria as the gold standard. Materials and methods: Cross-sectional study that included women with more than 20 weeks of gestation, admitted to Clinica Universitaria Bolivariana in Medellín because of suspected preeclampsia. Pregnant women with urinary infection at the time of the study, patients with a history of chronic diseases that could cause proteinuria, and women who did not complete the sample collection were excluded. Urine protein/creatinine ratio as well as proteinuria were measured in all the patients included in the study. The correlation between the two tests and the cut-off point for the protein/creatinine ratio with the best performance for the detection of significant proteinuria were evaluated. Results: Overall, 200 urine samples were included and significant proteinuria was found in 27 % of the total number of samples. The protein/creatinine ratio in occasional urine was found to have a high correlation with 24-hour proteinuria(r = 0.775, p < 0.01). The cut-off point with the best performance for detecting significant proteinuria was found to be 0.30 mg /mg, with an 83 % sensitivity and a 98 % specificity, with a positive LR of 60 and a negative LR of 0.17. Conclusion: The protein/creatinine ratio in occasional urine may be used as a fast alternative method for determining the presence of proteinuria in patients with suspected preeclampsia.

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