Pancreatic disorders of pregnancy. Pregestational diabetes.

The outcome of pregnancies complicated by pregestational diabetes, both insulin-dependent and non-insulin-dependent, has changed dramatically since the discovery of insulin in the early 1920s. Now, patients with pregestational diabetes can safely undergo a pregnancy and be assured that the infant will be healthy. Unfortunately, a finite risk of problems still may occur, including congenital malformations, spontaneous abortions, and diabetic fetopathy classically manifest as a macrosomic infant. Treatment strategies, although tedious and sometimes onerous, do minimize these risks.