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Diabetes mellitus gestacional

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  • Descripción general
  • Teoría
  • Diagnóstico
  • Manejo
  • Seguimiento
  • Recursos
Última revisión: 26 Nov 2025
Última actualización: 13 Aug 2025

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • presencia de factores de riesgo (generalmente asintomáticos)
Todos los datos

Otros factores de diagnóstico

  • poliuria
  • polidipsia
  • macrosomía fetal en un embarazo anterior
Todos los datos

Factores de riesgo

  • 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)
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • test de tolerancia a la glucosa oral (PTGO)
Todos los datos

Pruebas diagnósticas que deben considerarse

  • glucosa en sangre (plasmática) al azar
  • HbA1c
  • glucosa plasmática en ayunas
Todos los datos

Algoritmo de tratamiento

Agudo

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

Colaboradores

Autores

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

Divulgaciones

ES has delivered lectures and educational events for numerous organisations. She has received honoraria for talks/workshops given by Ypsomed and Lilly Diabetes Care. ES has received research grant support from the National Institute for Health and Care Research (NIHR), Abbott Diabetes Care, and the Medical Research Council (MRC) - this has gone directly to her University of Leeds employer. All of the above relate to the theme of diabetes in pregnancy. She has no contractual agreements to disseminate any product information.

Rebecca Spencer, MBChB, BSc, MRCOG, PhD

NIHR Clinical Lecturer in Obstetrics and Gynaecology

University of Leeds

Leeds

UK

Divulgaciones

RS has received a grant from the Academy of Medical Sciences, funding from NIHR, travel and accommodation expenses from the Drug Information Association to speak at their European conference, and Tommy’s; none of these relate to the topic covered. RS has acted as an unpaid consultant to Comanche Biopharma, who are developing a novel therapy for pre-eclampsia.

Agradecimientos

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.

Divulgaciones

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.

Revisores por pares

Helen Murphy, MBBch, BAO, FRACP, MD

Clinical Professor in Medicine (Diabetes and Antenatal Care)

University of East Anglia

Norwich

UK

Declarações

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.

Créditos aos pareceristas

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Referências

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Principais artigos

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.Texto completo  Resumo

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.Texto completo  Resumo

American Diabetes Association. Standards of care in diabetes - 2025. Diabetes Care. 2025 Jan 1;48(Suppl 1):S344-52.Texto completo

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

Joint British Diabetes Societies for Inpatient Care Group (JBDS-IP). Managing diabetes and hyperglycaemia during labour and birth. Feb 2023 [internet publication].Texto completo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.

  • Diagnósticos diferenciais

    • Diabetes tipo 1
    • Diabetes de tipo 2
    Mais Diagnósticos diferenciais

  • Diretrizes

    • Standards of care in diabetes - 2025
    • Diabetes in pregnancy: management from preconception to the postnatal period
    Mais Diretrizes

  • Folhetos informativos para os pacientes

    Síndrome del ovario poliquístico: ¿qué es?

    Diabetes tipo 2: ¿Qué tratamientos funciona?

    Mais Folhetos informativos para os pacientes
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