Management of gestational diabetes

The author reports on the antenatal care and delivery of 409 pregnant women with gestational diabetes. Normal glucose levels were achieved by diet in 239 patients and by diet + insulin in 170 patients. In the course of setting the diet the author's aim was to maintain the 24 hour glucose profile between 3.5 and 6.5 mmol/l. Blood glucose values were found to be higher in patients treated by diet only, as compared with those who received insulin. The difference was, however, not significant. Of the complications of pregnancy, EPH gestosis, weak uterine contractions during labor, and intrauterine asphyxia were most frequently encountered. It is to be noted that the mean birthweight (3620 g) of newborns of very obese mothers was higher than that of the controls (3380 g), and the reported fetopathic cases (13) were also found in this group. Among the patients studied by author premature delivery occurred in 3.42%, and perinatal mortality in 1.2% of the cases.