[Diabetes mellitus and pregnancy (author's transl)].

In present day, recognized factors which influence the carbohydrate metabolism of a diabetic during pregnancy have been reviewed. Possible effects on the fetus are discussed. Based on the good results obtained by Roversi and Canussio with the "Maximal tolerated dose of insulin", a state of glycemia within the normal limits was sought; this aim is attained most readily with a 3-4 times daily injection of soluble insulin. With satisfactory control of metabolism and regular surveillance of fetal parameters (ultrasonics, CTG, oestriol, HPL), the time for delivery can approach the calculated date: thus, the danger of fetal respiratory distress is reduced. Also, fetal hyperinsulinism can be avoided by stabilising the diabetic condition as early as possible within the normal limits of glycemia. Spontaneous birth is attempted with preparations made for caesarean section.