Pregnancy and diabetes. Team approach.

Area of Science:

• Obstetrics and Gynecology
• Endocrinology
• Perinatology

Background:

• Diabetes in pregnancy affects 2% of all pregnant women annually.
• Historically, fetal mortality for diabetic pregnancies was nearly 100% before insulin discovery in 1922.
• Modern management has drastically improved outcomes, nearing those of non-diabetic pregnancies.

Purpose of the Study:

• To highlight the impact of blood glucose control on fetal outcomes in diabetic pregnancies.
• To discuss the role of glycosylated hemoglobin in reducing fetal malformations.

Main Methods:

• Review of historical and current data on fetal mortality in diabetic pregnancies.
• Analysis of blood glucose and glycosylated hemoglobin management strategies.
• Examination of animal and human studies on malformation reduction.

Main Results:

• Fetal mortality in diabetic pregnancies has significantly decreased due to strict blood glucose control (averaging <100 mg/dL/day).
• Normal glycosylated hemoglobin levels throughout pregnancy are crucial for improved outcomes.
• Elevated malformation rates persist, but early normalization of glycosylated hemoglobin shows promise.

Conclusions:

• Intensive glycemic management is key to reducing fetal mortality in diabetic pregnancies.
• Achieving normal glycosylated hemoglobin levels at conception is critical for minimizing fetal malformations.
• Continued research into glycemic control strategies is essential for optimizing pregnancy outcomes.