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February 1986

Control of Overt Maternal Diabetes During Pregnancy in a County Hospital

Author Affiliations

From the Division of Endocrinology, Department of Medicine, Cook County Hospital, Chicago.

Arch Intern Med. 1986;146(2):311-315. doi:10.1001/archinte.1986.00360140133019

• 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.

(Arch Intern Med 1986;146:311-315)

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