RECOGNITION AND MANAGEMENT OF PROBLEMS ASSOCIATED WITH PREDIABETES DURING PREGNANCY

Abstract

Glucose-tolerance curves were obtained from 790 patients whose pregnancy records suggested impairment of carbohydrate metabolism. Among the patients whose fasting glucose levels were less than 120 mg. per 100 cc. of blood there were 111 whose two-hour glucose levels (THGL's) exceeded that figure. Forty-three of these had THGL's between 140 and 170 mg. per 100 cc. and were designated as prediabetic; 33 had THGL's exceeding 170 mg. per 100 cc. and were designated as having gestational diabetes. The treatment of prediabetes and gestational diabetes was essentially dietary and was successful in keeping the postprandial blood glucose levels below 140 mg. per 100 cc. in all but four patients; these four, in the group with gestational diabetes, required some insulin. Of the 111 cases, 46 were detected early enough in pregnancy to permit adequate treatment and in these there were no fetal losses. Among the rest there was much neonatal morbidity, with a 25.6% infant mortality rate among the 39 cases unregistered or unrecognized before delivery. The striking difference between treated and untreated patients indicates that early diagnosis is important. Due prenatal care and close postnatal observation can greatly improve the outlook for a prediabetic woman and her child.