Optimal insulin delivery for the pregnant diabetic patient.

It is now possible to virtually normalize ambient blood glucose levels in insulin-dependent diabetic women during pregnancy. Successful programs have been developed that utilize home blood glucose monitoring, physiologic delivery of insulin, and quantitation of caloric intake carefully matched to insulin dosage. The results of establishing normoglycemia throughout gestation appear to be a normalization of mortality and morbidity for both infant and mother. Pregnancy provides a need for continuous upward adjustment of insulin dose concomitant with the ongoing fetal and hormonal changes associated with gestation.