Management of diabetes during pregnancy.

Evidence now exists that maintaining normal maternal plasma glucose in the diabetic mother results in an infant mortality risk equal to that in the general population and may reduce the late fetal complications of maternal diabetes: macrosomia and perinatal hypoglycemia. Careful attention to diet, home glucose monitoring, multiple insulin injections, and frequent dose adjustments are often required to achieve this goal. Since organ development occurs within the first few weeks after conception, pregnancy planning and optimization of diabetes management prior to pregnancy is critical to good outcome in diabetic women eager to begin a family.