Pregnancy in Type I (Insulin-Dependent) Diabetes

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Information on the following points is obligatory: Risks for the Child Perinatal mortality in children of diabetic mothers is a function of maternal glycemia during pregnancy (Jovanovic and Peterson 1980). Maternal hyperglycemia during the phase of organ development (first trimester) leads to an increase in the risk of malformation. During the further course of pregnancy, especially during the third trimester, it causes reactive fetal hyperinsulinemia, which leads to macrosomia and pronounced hypoglycemia in the newborn. Optimal metabolic control from the beginning of the pregnancy can almost completely eliminate the excessive perinatal mortality of children of diabetic mothers (Fuhrmann et al. 1983, Miller et al. 1983). Probability of Diabetes in Children of Diabetic Mothers Contrary to previous beliefs, the probability that a child of a type I diabetic mother will also develop diabetes is very low, approx. 1–3% (Warram et al. 1984). Risk for the Diabetic Mother Any existing late complications of diabetes increase the risk to both mother and child. Angiopathy multiplies the risk of late gestosis (preeclampsia). Care should therefore be especially intensive if any of the following conditions are present: long duration of diabetes (and/or early manifestation of diabetes in the mother); retinopathy; nephropathy (increased microproteinuria, hypertension, pyelonephritis).