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Diabetes mellitus gestacional

  • Visão geral
  • Teoria
  • Diagnóstico
  • Tratamento
  • ACOMPANHAMENTO
  • Recursos
Last reviewed: 20 Aug 2025
Last updated: 06 Dec 2024

Summary

Definition

History and exam

Key diagnostic factors

  • presencia de factores de riesgo (generalmente asintomáticos)
Full details

Other diagnostic factors

  • poliuria
  • polidipsia
  • macrosomía fetal en un embarazo anterior
Full details

Risk factors

  • índice de masa corporal (IMC) elevado
  • diabetes gestacional previa
  • anterior bebé macrosómico
  • antecedentes familiares de diabetes mellitus
  • ascendencia no blanca
  • edad materna avanzada (>40 años)
  • síndrome del ovario poliquístico (SOPQ)
Full details

Diagnostic tests

1st tests to order

  • prueba de tolerancia a la glucosa
Full details

Tests to consider

  • glucosa en sangre (plasmática) al azar
  • HbA1c
  • glucosa plasmática en ayunas
Full details

Treatment algorithm

ACUTE

glucosa plasmática en ayunas ≥7 mmol/L (≥126 mg/dL), o de 6 a 6.9 mmol/L (108-124 mg/dL) si el feto es de gran tamaño/polihidramnios

glucosa plasmática en ayunas <7 mmol/L (<126 mg/dL) sin feto grande/polihidramnios

trabajo de parto

Contributors

Authors

Eleanor Scott, BM, BS, MD, FRCP

Professor of Medicine (Diabetes and Maternal Health)

Leeds Institute of Cardiovascular and Metabolic Medicine

Leeds Centre for Diabetes and Endocrinology

Leeds

UK

Disclosures

ES has received honoraria for talks given by Abbott Diabetes Care and Lilly Diabetes Care. ES has received research grant support from Abbott Diabetes Care in conjunction with the Medical Research Council (MRC) through an MRC industry collaboration agreement - this has gone directly to her University of Leeds employer.

Rebecca Spencer, MBChB, BSc, MRCOG, PhD

NIHR Clinical Lecturer in Obstetrics and Gynaecology

University of Leeds

Leeds

UK

Disclosures

RS is in receipt of a National Institute for Health and Care Research Clinical Lectureship and an Academy of Medical Sciences Starter Grant. RS has acted as an unpaid consultant to Comanche Biopharma, who are developing a novel therapy for pre-eclampsia.

Acknowledgements

Dr Scott and Dr Spencer would like to gratefully acknowledge Dr Ellen W. Seely, Dr Chloe Zera, Dr Jeremy Soule and Dr Leonard E. Egede, previous contributors to this topic.

Disclosures

EWS and CZ declare that they have no competing interests. JS has undertaken research support and speakers' bureau activity for Novartis, Bristol Myers Squibb, Astra Zeneca, and Sanofi-Aventis. LEE is an author of a number of references cited in this topic.

Peer reviewers

Helen Murphy, MBBch, BAO, FRACP, MD

Clinical Professor in Medicine (Diabetes and Antenatal Care)

University of East Anglia

Norwich

UK

Disclosures

HM sits on the Medtronic (insulin pump and CGM manufacturer) European scientific advisory board. HM has received research support (CGM sensors and insulin pumps) at reduced cost from Medtronic, Dexcom, and Johnson & Johnson. MH has contributed to educational events sponsored by NovoNordisk, Medtronic, Dexcom, and Abbott Diabetes Care.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Metzger BE, Gabbe SG, Persson B, et al; International Association of Diabetes and Pregnancy Study Groups Consensus Panel. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010 Mar;33(3):676-82.Full text  Abstract

Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy: a World Health Organization Guideline. Diabetes Res Clin Pract. 2014 Mar;103(3):341-63.Full text  Abstract

American Diabetes Association. Standards of care in diabetes - 2023. Diabetes Care. 2023 Jan;46(Suppl 1):S1-291.Full text

National Institute for Health and Care Excellence. Diabetes in pregnancy: management from preconception to the postnatal period. Dec 2020 [internet publication].Full text

Plows JF, Stanley JL, Baker PN, et al. The pathophysiology of gestational diabetes mellitus. Int J Mol Sci. 2018 Oct 26;19(11):E3342.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

  • Differentials

    • Diabetes tipo 1
    • Diabetes de tipo 2
    More Differentials

  • Guidelines

    • Standards of care in diabetes - 2023
    • Diabetes in pregnancy: management from preconception to the postnatal period
    More Guidelines

  • Patient information

    Síndrome del ovario poliquístico: ¿qué es?

    Diabetes tipo 2: ¿Qué tratamientos funciona?

    More Patient information
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