Volume 1 number 1 Summer 2003
Special issue for the abstracts of the 7th Pan Arab Conference on Diabetes
PACD7 , 25 – 28 March 2003 Cairo

Abstract Number : 88
Gestational Diabetes

Amira Elsayed , MD , USA

During pregnancy in the insulin-dependent diabetic woman,periods of maternal hyperglycemia lead to fetal hyperglycemia and thus fetal pancreatic stimulation. The resulting fetal hyperinsulinemia is
associated with excessive fetal growth and other morbidities.

Congenital malformations are two to four times more common in the offspring of insulin-dependent diabetic women. Cardiac,central nervous system,and skeletal malformation are most commonly observed.Poor
glycemic control during organogenesis is associated with an increase risk for malformation.

Women with diabetic nephropathy are at increased risk for pre-eclampsia,fetal growth retardation,and early delivery. Management involves control of maternal hypertension and intensive fetal surveillance.

Screening for gestational diabetes, a disorder of carbohydrate intolerance discovered during pregnancy, should be undertaken at 24 to 28 weeks's gestation using a 1 hour 50-g oral glucose challenge. 

Delivery of the insulin-dependent diabetic should be delayed until fetal maturation has taken place,provided that that the patient is well controlled and that antepartum fetal surveillance remains reassuring

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