[Type I diabetes mellitus and pregnancy: an interdisciplinary management program]

Area of Science:

• Obstetrics and Gynecology
• Endocrinology
• Perinatology

Context:

• Pregnancy management for women with pregestational diabetes has evolved significantly.
• Historically, achieving stable blood glucose levels required prolonged hospitalization.
• A new interdisciplinary protocol aims to improve outcomes through patient self-management.

Purpose:

• To evaluate the effectiveness of a functional insulin therapy protocol for pregnant women with pregestational diabetes.
• To assess maternal metabolic control and neonatal outcomes using near-normoglycemic insulin substitution (NIS).

Summary:

• The study involved 18 pregnant women with pregestational diabetes, with 8 deliveries reported.
• The protocol utilizes home glucose monitoring and algorithm-based self-adjusted insulin therapy (NIS).
• Maternal metabolic variables remained within normal limits, with average gestational age at delivery of 37.8 weeks and average birth weight of 3293 grams.

Impact:

• The NIS protocol resulted in favorable maternal weight gain and gestational age at delivery.
• All newborns were within the 50th percentile for birth weight, with no congenital malformations, macrosomia, or neonatal hyperglycemia.
• Preliminary results suggest NIS is a promising and effective management strategy for motivated pregnant diabetic patients.