Resumo
განსაზღვრება
History and exam
Key diagnostic factors
- presença de fatores de risco (geralmente assintomáticos)
Other diagnostic factors
- poliúria
- polidipsia
- macrossomia fetal em uma gravidez prévia
Risk factors
- índice de massa corporal (IMC) elevado
- diabetes gestacional pregressa
- bebê macrossômico prévio
- história familiar de diabetes mellitus
- ascendência não branca
- idade materna avançada (>40 anos)
- síndrome do ovário policístico (SOPC)
Diagnostic investigations
1st investigations to order
- teste oral de tolerância à glicose (TOTG)
Investigations to consider
- glicose sanguínea (plasmática) aleatória
- HbA1c
- glicemia de jejum
Treatment algorithm
glicemia de jejum ≥7 mmol/L (≥126 mg/dL), ou 6 a 6.9 mmol/L (108-124 mg/dL) se houver feto grande/polidrâmnio
glicemia de jejum <7 mmol/L (<126 mg/dL) sem feto grande/polidrâmnio
trabalho 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
Раскрытие информации
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
Раскрытие информации
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.
Выражение благодарностей
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.
Раскрытие информации
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.
Рецензенты
Helen Murphy, MBBch, BAO, FRACP, MD
Clinical Professor in Medicine (Diabetes and Antenatal Care)
University of East Anglia
Norwich
UK
Раскрытие информации
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.
Список литературы
Основные статьи
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.Полный текст Аннотация
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.Полный текст Аннотация
American Diabetes Association. Standards of care in diabetes - 2025. Diabetes Care. 2025 Jan 1;48(Suppl 1):S344-52.Полный текст
National Institute for Health and Care Excellence. Diabetes in pregnancy: management from preconception to the postnatal period. Dec 2020 [internet publication].Полный текст
Joint British Diabetes Societies for Inpatient Care Group (JBDS-IP). Managing diabetes and hyperglycaemia during labour and birth. Feb 2023 [internet publication].Полный текст
Статьи, указанные как источники
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Отличия
- Diabetes do tipo 1
- Diabetes do tipo 2
Больше ОтличияGuías de práctica clínica
- Standards of care in diabetes - 2025
- Diabetes in pregnancy: management from preconception to the postnatal period
Больше Guías de práctica clínicaFolletos para el paciente
Diabetes do tipo 2: devo tomar insulina?
Diabetes: o que posso fazer para me manter saudável?
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