Resumen

LIMA, Marcos M  y  GRUPO DE ENDOCRINOLOGIA MERIDA et al. Manejo de la diabetes gestacional: Protocolo del Servicio de Endocrinología del Instituto Autónomo Hospital Universitario de los Andes. Rev. Venez. Endocrinol. Metab. [online]. 2012, vol.10, n.2, pp.88-93. ISSN 1690-3110.

Gestational diabetes (GD) is defined as any degree of glucose intolerance that begins or is first recognized during pregnancy. Risk factors for GD include diabetes in a first-degree relative, history of glucose intolerance, marked obesity and a previous infant with macrosomia. GD classically presents in the third trimester of pregnancy, as a result of the production of placental hormones which help to generate a state of insulin resistance that normally ceases after delivery of the placenta. Glucose crosses the placenta and stimulates fetal insulin production. Because insulin has growth-promoting properties, the result is fetal macrosomia and an increased rate of cesarean sections. However, although the impact of GD on maternal and fetal health is widely recognized, there is not a universal consensus on the diagnostic methods and treatment strategies. In this paper, based on levels of scientific evidence and clinical practice in the Unit of Endocrinology, IAHULA, we present the protocol for the management of GD, which includes: diagnostic criteria, clinical management, treatment, fetal surveillance and postpartum maternal management.

Palabras clave : gestational diabetes; diabetes; macrosomia; insulin.