[Antidiabetic treatment and monitoring during pregnancy in diabetes].
In pregnant diabetic women one of the goals of antidiabetic treatment and monitoring is to maintain blood glucose near normal values between 4.4 and 6.1 mmol/l. If possible such values should be obtained before conception. To reach these goals four components of health care delivery are of major importance. Education dealing with contraception and planification of the pregnancy, diet modified according to the state of pregnancy, self blood glucose monitoring to allow anticipatory optimized insulin therapy. During pregnancy the systematic use of continuous subcutaneous insulin infusion does not seem to be associated with any significant benefit dealing with metabolic control or the perinatal and neonatal morbidity and mortality. In pregnant diabetic patients the usefulness of the dosage of glycated haemoglobin is limited due to the spontaneous fluctuations of this value during pregnancy, as well as the delay of the variation of this index during a period of poor glycemic control. In this condition glycated proteins as fructosamine may be more useful but many technical problems for this determination are still to be solved.
Service d'Endocrinologie Diabétologie, Hôpital Saint-Louis, Paris.
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D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism*; D001798:Blood Proteins / Q000032:analysis; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006023:Glycoproteins; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D008991:Monitoring, Physiologic; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000097:blood / Q000188:drug therapy*; D000093422:Glycated Serum Proteins
D015415:Biomarkers; D001786:Blood Glucose; D001798:Blood Proteins; D006442:Glycated Hemoglobin; D006023:Glycoproteins; D007004:Hypoglycemic Agents; D007328:Insulin; D000093422:Glycated Serum Proteins
Le traitement antidiabétique et la surveillance chez la diabétique enceinte.