Abstract
1) Objective
Recently there has been an increasing number of pregnant diabetics in Japan as in many other developed countries. Pregnancy normally involves marked endocrinolo3ic and metabolic changes. Coexisting diabetes is therefore likely to have significant influence on both the maternal body and the fetus. While the fact that pregnancy is diabetogenic is of metabolic interest, the chronic fetal distress that may occur in pregnant diabetics is of obstetrical importance. The present study was undertaken to investigate the control of pregnant diabetics from the obstetric and diabetic standpoints.
2) Method
Fifteen normal nonpregnant women, 56 normal pregnant women and 11 pregnant diabetics (falling into class A or B according to White's classification) were used in this study. A glucose tolerance test (GTT) was performed and blood sugar, IRI response and ΔIRI/ΔBS were measured on all subjects. For the pregnant diabetic obstetrical linings were noted. Also urinary estriol, serum HPL and serum HCG were determined serially during the terminal stage of pregnancy.
3) Results
Blood glucose and IRI response curves varied during the GTT with different groups of subjects. In normal pregnancy the IRI response increased from the first to the second and on into the third trimester. In class A pregnant diabetics the IRI response was delayed in elevation. In class B-diabetics the IRI response curve was low and the ΔIRI/ΔBS also was low. Serum HPL and serum HCG were elevated at times in the presence of diabetes, but in some cases they decreased after the 35th week of pregnancy. In well controlled diabetics the urine estriol level was stationary throughout pregnancy, but it began to decline from the 36th week in some cases and remained about 10mg/day in others. Infants of mothers with placental dysfunction were not viable due to various complications. From these results it was concluded that monitoring of endocrine function is essential for the successful control of pregnant diabetics.
