[Diabetes monitoring for the pregnant diabetic].
Diabetological care in pre-gestational (preGDM) and gestational (GDM) pregnant diabetic is an indispensable factor for the reduction of risk of mother, fetus and newborn complications. The adoption of an intensified therapy, aiming at maintaining almost normal glycemic values, and the improvement in fetal monitoring have led to a marked reduction, for instance, in fetal intrauterine death and in perinatal mortality rate in general. Furthermore, pregnancy programming allows good glycemic control since conception and a decrease in malformations. It is therefore, necessary to create interdisciplinary teams treating pregnant diabetics coordinately. Diabetological care involves the evaluation of risks from the first phases to the end of the pregnancy, therapeutical decisions on the basis of metabolic and non-metabolic parameters, the education of diabetic women, the coordination of the other specialized interventions and delivery programming together with the obstetrician and the neonatologist. The programs of checks to be executed on pregnant diabetics, during hospitalization and on outpatients, are here illustrated considering the meaning of: fasting glycemia and spontaneous glycemic curves, with goals both in preGDM and in GDM; HbA1c and fructosamine; glycosuria and ketonuria; plasmatic lipids and uricaemia; other non-metabolic checks, in particular blood pressure one.
Dradi Maraldi
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C
Servizio di Diabetologia e Malattie del Ricambio, Ospedale Maurizio Bufalini, Cesena, Forlì.
Santini
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C
D000553:Ambulatory Care; D001786:Blood Glucose / Q000032:analysis; D005260:Female; D005315:Fetal Diseases / Q000209:etiology / Q000517:prevention & control; D019270:Fructosamine; D006442:Glycated Hemoglobin / Q000032:analysis; D006595:Hexosamines / Q000097:blood; D006760:Hospitalization; D006801:Humans; D007659:Ketones / Q000652:urine; D011247:Pregnancy; D011256:Pregnancy Outcome; D011254:Pregnancy in Diabetics / Q000378:metabolism / Q000628:therapy; D011295:Prenatal Care; D018570:Risk Assessment
D001786:Blood Glucose; D019270:Fructosamine; D006442:Glycated Hemoglobin; D006595:Hexosamines; D007659:Ketones
La sorveglianza diabetologica nella gravida diabetica.