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April 1986

Pregnancy and Diabetes: Team Approach

Author Affiliations

From the Diabetes and Metabolism Clinic (Dr Levin), the Division of Maternal-Fetal Medicine (Dr Rigg), and the Department of Pediatrics (Dr Marshall), Washington University School of Medicine, St Louis; the Jewish Hospital of St Louis (Dr Levin); and the Division of Neonatology, St Louis Childrens' Hospital (Dr Marshall).

Arch Intern Med. 1986;146(4):758-767. doi:10.1001/archinte.1986.00360160194026

• Each year, 10,000 babies are born to diabetic women. Gestational diabetes occurs in 2% of all pregnant women, resulting in 60,000 to 90,000 cases of gestational diabetes yearly. Prior to 1922 and the discovery of insulin, fetal mortality for the pregnant diabetic was almost 100%. Today, total fetal mortality for the pregnant and gestational diabetic is approaching that of the nondiabetic. This has been achieved by extremely tight control of blood glucose levels throughout pregnancy, with blood glucose levels averaging under 100 mg/dL/day and glycosylated hemoglobin levels in the normal range throughout pregnancy. An increased number of malformations in fetuses of pregnant diabetic women is still a problem. However, animal and human studies indicate that a normal level of glycosylated hemoglobin at conception may significantly reduce these malformations.

(Arch Intern Med 1986;146:758-767)

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