[Management of pregnant diabetics]

The impressive decrease in perinatal mortality rates among the offspring of diabetic mothers, reported from many centres during the past 50 years (Fig. 1), is attributed to a multiplicity of factors, in particular improvements in the diabetic control of prospective mothers, both before conception and during pregnancy. Centres for preconceptional counselling and pregnancy planning and for diabetic gravidae management, are to be strongly recommended. In cases where diabetic is diagnosed during pregnancy, the diabetic gravidae centre should assume responsibility for the regular follow-up of these women. Although the combined efforts of diabetologists, obstetricians and neonatologists have resulted in substantial reduction of perinatal mortality and the frequency of severe congenital malformations among the offspring of diabetic mothers, there has been less reduction in the frequency of pregnancy complications and less improvement in long-term prognosis for the offspring of diabetic mothers.