Management of Diabetes Mellitus in Pregnancy: Survey of Maternal-Fetal Medicine Subspecialists in the United States

Abstract

The management of pregnancies complicated by both insulin-dependent and gestational diabetes mellitus has changed dramatically in the United States during the past 15 years. Recommended programmes of care have been outlined in a Technical Bulletin published by the American College of Obstetricians and Gynecologists in 1986, as well as in the summary of the Second International Workshop Conference on Gestational Diabetes Mellitus in 1984 (Freinkel et al. 1985), at which the American College of Obstetricians and Gynecologists was also represented. However, even these documents do not agree, particularly in their approach to screening for gestational diabetes mellitus. This study was undertaken, therefore, to determine the state of the art in the care of pregnancies complicated by both gestational and insulin-dependent diabetes mellitus in the United States.