Abstract

MEDINA-PEREZ, EA et al. Gestational diabetes mellitus. Diagnosis and treatment in the first level of care. Med. interna Méx. [online]. 2017, vol.33, n.1, pp.91-98. ISSN 0186-4866.

Gestational diabetes mellitus is defined as any carbohydrate intolerance first diagnosed during pregnancy. The prevalence of gestational diabetes mellitus is about 2-5% of normal pregnancies and depends of the prevalence of same population to diabetes mellitus type 2. It is associated with adverse outcome for the mother, the fetus, neonate, child and adult offspring of the diabetic mother. Detection of gestational diabetes mellitus lies on screening, followed as necessary by diagnostic measures. Screening can either be selective, based upon risk stratification or universal. Timely testing enables the obstetrician to assess glucose tolerance in the presence of the insulin-resistant state of pregnancy and permits treatment to begin before excessive fetal growth has occurred. Once a diagnosis of gestational diabetes mellitus was made close perinatal surveillance is warranted. The goal of treatment is reducing fetal-maternal morbidity and mortality related with gestational diabetes mellitus. The exact glucose values needed are still not absolutely proved. The decision whether and when to induce delivery depends on gestational age, estimated fetal weight, maternal glycemic control and bishop score. Future research is needed regarding prevention of gestational diabetes mellitus, treatment goals and effectiveness of interventions, guidelines for pregnancy care and prevention of long term metabolic sequel for both the infant and the mother.

Keywords : gestational diabetes; diagnosis; treatment; first level of care.

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