[Increased insulin requirement in pregnant diabetics (author's transl)]

In 25 insulin-dependent female diabetics of the B to D categories according to White, the daily insulin requirement was determined between the 8th and 40th week of pregnancy. The purpose of this study was to keep the mean blood sugar below 100 mg% by means of administration of old insulin. From the 28th week the metabolic balance was additionally modified by means of the insulin content of the amniotic fluid. In all cases spontaneous initiation of delivery was awaited. All women gave birth to healthy babies of normal weight without any sign of diabetogenic foetopathy. The insulin requirement of the whole group rose from an average of 32 units in the 8th week to 66 units in the 36th week of pregnancy and decreased subsequently. The requirement increases at first as represented by a flat curve which acquires a distinctly greater slope between the 28th and 36th weeks. In White B, C, and D diabetics the initial requirement is on the average 23, 35 and 45 units per 24 hours. the maximum requirement being on the average 2.4, 2.0 or 1.7 times the initial figure. The drop in insulin requirement after the 36th week is physiological and does not point to any hazard as far as the foetus is concerned.