Control of overt maternal diabetes during pregnancy in a county hospital.
Tight metabolic control of manifest diabetes during pregnancy was attempted in 51 clinic referrals to a county hospital. Starting before the 28th week of gestation, a good control of diabetes was achieved with the help of initial hospitalization, regular home blood glucose monitoring, and frequent clinic visits. Mean preprandial plasma glucose level was 96.4 +/- 22.6 mg/dL. A mean preprandial plasma glucose level of less than 110 mg/dL was achieved in 42 (82%) of the 51 patients. Total perinatal mortality was 7.7% (4/52). When we excluded major maternal morbidity unrelated to diabetes that accounted for fetal loss, the corrected perinatal loss was 3.8%. Significant maternal hypoglycemia was uncommon. Major congenital malformations in the fetus, neonatal hyperbilirubinemia, and neonatal hypoglycemia each occurred in fewer than 5%. These results suggest that good metabolic control of diabetes is achievable in patients in a general hospital and it may lower fetal loss and morbidity associated with overt maternal diabetes.
D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D000013:Congenital Abnormalities / Q000209:etiology; D036861:Delivery, Obstetric; D003927:Diet, Diabetic; D005260:Female; D006760:Hospitalization; D006766:Hospitals, County; D006801:Humans; D007231:Infant, Newborn; D007328:Insulin / Q000627:therapeutic use; D008991:Monitoring, Physiologic; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000097:blood / Q000150:complications / Q000401:mortality / Q000628:therapy*; D013997:Time Factors
D001786:Blood Glucose; D007328:Insulin