Diabetes in pregnancy: update, myths and facts

Abstract

Metabolic alterations in pregnancy Increase neonatal morbidity and mortality. Its frequency varies depending on the methods used; at present some of them have demonstrated their clinical efficacy such as the screening with 50 grs. of glucose, fructosamine and glicolised hemoglobin. By the rational use of these methods it is possible to discriminate different diagnosis of Intolerance and start early therapeutic measures. Family and personal histories of the pregnant woman are two basic elements to support the clinical search; risk factors do not exclude the necessity of the screening of this pathology. Pregnancy is considered a diabetogenic condition provoking serious fetal disturbances that increase neonatal morbimortality. Phisiopathological media conditions of mother and fetus and their diagnostic Implications are reviewed. Finally different clinical monitoring are presented permitting to start early and adequate therapeutic measures based on the three fundamental postulates: diet, physical exercise and Insulin. It is very important to continue a strict post-partum follow up In order to detect some patients that may persist in presenting carbohydrate Intolerance alterations.