Treatment of diabetes mellitus and pregnancy.

The pregnancy of woman with diabetes mellitus poses a high risk. During the pre-insulin era the newborn had a 40% chance of survival and there was high mortality in the mothers. Only in recent years has it been possible to decrease perinatal mortality to 2-4% due to the cooperation of diabetologists, obstetricians, and pediatricians in centers with much experience in supervision of mother and child. In the foreground of treatment are the following prerequisites: (1) close metabolic supervision of the mother allowing blood-glucose values between 60-120 mg/dl and mean blood glucose per day around 85 mg/dl during the course of pregnancy; (2) intensive supervision of the fetus; (3) early recognition and adequate treatment of complications. Close metabolic supervision succeeds only by way of blood-glucose self-control. To decrease the rate of deformities, the close metabolic supervision apparently has to commence before conception. This management no longer requires delivery according to the White scheme.