[Gestational diabetes: the use of an intensive treatment program at the regional level]

In this study the results are shown of the application of an intensified treatment program of Gestational Diabetes (GD) in a regional setting. From January 1991 to June 1995, 115 women with GD were attended at Mútua Hospital in Terrassa; 62.6% of them required insulin to optimize the metabolic control. When insulin dependent women were compared with non insulin dependent women, diagnosis was earlier; age, progestational age, serum glucose in the O'Sullivan test and diagnostic basal serum glucose in oral overload (GOO) were higher. Regarding perinatal results, the incidence of gestational hypertensive disturbances, hydramnios, and urinary tract infections were 7%, 1.7%, and 8%, respectively. Perinatal mortality was 0.86%. Delivery occurred after 37 weeks in 96.5% of cases and the cesarean section was performed in 26%; nevertheless, this rate was similar to that in the obstetric population attended at this institution (25%). Birth weight was high for gestational age in 7.8% of newborns (NB) and low in 2.5%. Factors associated with fetal weight included progestational maternal weight, ponderal increase during pregnancy and metabolic control (HbA1c). The present study suggests that the application of an intensified treatment program for GD can be carried out in a regional setting and with overall successful results.