Clinical guidelines for the management of gestational diabetes and pregestational diabetes were prepared by the Diabetes and Pregnancy Working Group, during the XI Brazilian Diabetes Congress, held in 1997. Selective screening of pregnant women based on the presence of risk factors is advised beginning at the 20th week of gestation, using a fasting plasma glucose. Cut points of 85mg/dl or 90mg/dl are used to classify a positive screening. A 75g oral glucose tolerance test is performed if the screening test is positive. Diagnostic cut points suggested by the World Health Organization are endorsed (fasting plasma glucose ³126mg/dl or 2h plasma glucose ³140mg/dl). Endocrine and obstetric management of gestational diabetes as well as a review on pre-gestational diabetes management are also presented.
gestational diabetes; diabetes and pregnancy; screening; diagnosis; treatment
