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Treatment of diabetes mellitus and pregnancy
The pregnancy of woman with diabetes mellitus poses a high risk. During the pre-insulin era the newborn had a 40% chance of survival and there was high mortality in the mothers. Only in recent years has it been possible to decrease perinatal mortality to 2-4% due to the cooperation of diabetologists, obstetricians, and pediatricians in centers with much experience in supervision of mother and child. In the foreground of treatment are the following prerequisites: (1) close metabolic supervision of the mother allowing blood-glucose values between 60-120 mg/dl and mean blood glucose per day around 85 mg/dl during the course of pregnancy; (2) intensive supervision of the fetus; (3) early recognition and adequate treatment of complications. Close metabolic supervision succeeds only by way of blood-glucose self-control. To decrease the rate of deformities, the close metabolic supervision apparently has to commence before conception. This management no longer requires delivery according to the White scheme.
The pregnancy of woman with diabetes mellitus poses a high risk. During the pre-insulin era the newborn had a 40% chance of survival and there was high mortality in the mothers. Only in recent years has it been possible to decrease perinatal mortality to 2-4% due to the cooperation of diabetologists, obstetricians, and pediatricians in centers with much experience in supervision of mother and child. In the foreground of treatment are the following prerequisites: (1) close metabolic supervision of the mother allowing blood-glucose values between 60-120 mg/dl and mean blood glucose per day around 85 mg/dl during the course of pregnancy; (2) intensive supervision of the fetus; (3) early recognition and adequate treatment of complications. Close metabolic supervision succeeds only by way of blood-glucose self-control. To decrease the rate of deformities, the close metabolic supervision apparently has to commence before conception. This management no longer requires delivery according to the White scheme.