Abstract

PIP: The rate of birth abnormalities is 4-10 times higher in diabetic mothers than in the normal population. Mice embryos exposed to hyperglycemia increased developmental abnormalities (mostly before the 7th week of pregnancy) in linear fashion, while insulin treatment lowered them. The high level of glycosylated hemoglobin (HbAlC) during this period is associated with frequent abnormalities. In 116 diabetic women abnormal embryos were found in 22% of cases when HbAlC was 8.5%, while only 3% of the embryos were abnormal when HbAlC was 8.5%. Pregnant women whose diabetes was balanced from the 8th week of pregnancy had a 5.5% rate of abnormality compared to only .8% in those treated 3 months before pregnancy, and they also had fewer complications during pregnancy. The diabetic woman planning a pregnancy should have it earlier in life, get examined for nephropathy, retinopathy (treated by photocoagulation), hypertension, and ischemic heart disease. If these diseases are severe pregnancy is not advised. Before and during pregnancy sugar level must be checked 6-7 times a day and imbalance treated by insulin injections, or subdermal insulin pump in severe cases. Pregnancy is recommended only if the daily sugar balance is satisfactory, and the HbAlC value is less than 8%.