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Management of the pregnant diabetic

Riassunto

Il presente lavoro rappresenta una guida pratica per il trattamento della diabetica gravida. Il successo terapeutico dipende soprattutto da 4 fattori: 1) diagnosi precoce delle concomitanti condizioni diabetica e gravidica; 2) adeguato controllo del diabete; 3) termine della gravidanza in epoca prestabilita, ma non necessariamente prima del tempo normale; 4) collaborazione tra ostetrico, internista e pediatra per quanto riguarda il trattamento della paziente. Vengono commentati alcuni aspetti del diabete mellito riguardanti la storia, la fisiopatologia, il valore del test di tolleranza al glucosio, il trattamento dietetico e le modalità ottimali per l'espletamento del parto.

Résumé

Ce travail représent une guide pratique pour le traitement de la diabétique enceinte. Le succès de la thérapie dépend surtout de quatre facteurs: 1) diagnostic précoce soit du diabète que de la grossesse; 2) contrôle satisfaisant du diabète; 3) terme de la grossesse à date préfixée, mais pas nécéssairement avant terme; 4) collaboration entre accoucheur, spécialiste de médecine interne et pédiatre en ce qui concerne le traitement de la malade. Certains aspects du diabète sucré — histoire, physiopathologie, importance du test d'hyperglycémie provoquée, traitement diététique et modalités optimales pour l'accouchement — sont discutés.

Resumen

El presente trabajo representa una guía práctica para el tratamiento de embarazada diabética. El éxito terapéutico depende sobre todo de 4 factores: 1) diagnóstico precoz de las condiciones concomitantes de diabetes y embarazo; 2) adecuado control de la diabetes; 3) término del embarazo en época preestablecida, pero no necesariamente antes del término; 4) colaboración entre el obstétrico, internista y pediatra en lo que concierne al tratamiento de la paciente. Se comentan algunos aspectos de diabetes melito que conciernen a la historia clínica, a la fisiopatología, al valor del test de tolerancia a la glucosa, el tratamiento dietético y las mejores modalidades para el desarrollo del parto.

Zusammenfassung

Die vorliegende Arbeit ist ein praktischer Wegweiser zur Behandlung der diabetischen Schwangeren. Der Behandlungserfolg hängt vor allem von vier Faktoren ab: 1) Frühdiagnose des Diabetes und der Schwangerschaft; 2) ausreichende Kompensation des Diabetes; 3) Beendigung der Schwangerschaft zum im Voraus bestimmten Zeitpunkt, der nicht unbedingt vor dem errechneten Geburtstermin liegen muss; 4) Zusammenarbeit zwischen Geburtshelfer, Internist und Kinderarzt in Bezug auf die Behandlung der Patientin. Es werden einige Aspekte des Diabetes mellitus besprochen in Hinsicht auf Geschichte, Pathophysiologie, Wert der Zuckerbelastungsproben, diätetische Führung und optimales Vorgehen bei der Entbindung.

Summary

This paper is presented as a practical guide to the management of pregnant diabetics. The essence of a successful outcome depends on four factors: 1) early diagnosis of the concomitant conditions of pregnancy and diabetes; 2) adequate control of the diabetes; 3) planned termination of the pregnancy but not necessarily prior to term; 4) team approach to management including obstetrician, internist and pediatrician. Some comments about diabetes mellitus are made regarding: history, pathophysiology, value of glucose tolerance tests, dietary management and preferred methods of delivery.

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Delaney, J.J., Makowski, E.L. Management of the pregnant diabetic. Acta diabet. lat 8, 1–25 (1971). https://doi.org/10.1007/BF01550855

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Key-words

  • Diabetic mother
  • Diabetic pregnancy
  • Newborn of diabetic mother
  • Pregnancy
  • Therapy