A spectrum of glucose thresholds may effectively prevent complications in the pregnant diabetic patient.
This article outlines the probable positive relationship between levels of maternal glycemia and perinatal morbidity and mortality. A spectrum of different glucose thresholds can be established and used appropriately to prevent each complication. This article also outlines the concept of normality and what definitions of normality should be used to evaluate the relationship between the level of glycemia and perinatal outcome. Definitive conclusions are hampered by a lack of uniformity in definitions and interventions, and by a failure in some analyses to control for confounding variables. However, it is suggested that different levels of glycemia are required to prevent different diabetic complications. Thus, although it is not always possible to achieve targeted levels of glycemic control in all patients, any improvement will be beneficial because it will affect fetal complications associated with that glucose threshold.
Langer
Oded
O
Department of Obstetrics and Gynecology, St Luke's-Roosevelt Hospital Center, New York, NY 10019, USA.
D000022:Abortion, Spontaneous / Q000517:prevention & control; D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism*; D000013:Congenital Abnormalities; D005260:Female; D005320:Fetal Macrosomia / Q000517:prevention & control; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000097:blood* / Q000517:prevention & control; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000517:prevention & control*; D011254:Pregnancy in Diabetics / Q000097:blood*
D001786:Blood Glucose; D006442:Glycated Hemoglobin