Subclinical and Clinical Diabetes Complicating Pregnancy

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Abstract
Evidence shows that untreated maternal diabetes results in a high stillbirth rate and a neonatal mortality of approximately 30 per cent. A diabetic detection program for gravid women has not been accepted because of differing opinions on the effects of pregnancy on carbohydrate tolerance in normal women and on the most reliable testing method to be used during gestation. The oral glucose tolerance test is the most widely employed. It is suggested that in addition the cortisone-modified glucose tolerance test should be used in the late puerperium of patients in the suspect and latent diabetes groups. Clinical observations in diabetic pregnancies discussed by the author include increased insulin resistance and susceptibility to toxemia and urinary tract infection, effects of maternal diabetes on the fetus, and optimal timing and mode of delivery.