The impact of ambulatory glycemic control on the insulin-dependent diabetic gravida

The pursuit of maternal euglycemia is the cornerstone of contemporary perinatal management of the insulin-requiring diabetic gravida and its achievement has been associated with reduced perinatal morbidity and mortality. The maternal and perinatal results of a pregnancy management protocol for insulin-requiring diabetic gravidas which emphasizes rigorous glucose control via ambulatory patient utilization of reflectance meter determinations of fasting and two-hour postprandial blood glucose is summarized in this report. The authors describe the excellent maternal and neonatal outcomes achieved with this protocol, and emphasize the efficacy of this ambulatory approach to the treatment of insulin-dependent diabetic pregnancies.