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| Categories: Diabetes in everyday life |
| Diabetes in everyday life | |
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Maternal diabetes and malformation
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As already mentioned, the pregnancy of a diabetic always is very risky. A diabetic metabolism is the most frequent cause of a child's perinatal mortality due to various malformations. The basis of the following study were all births in the Parkland Hospital Dallas between 1991 and 2000. The women had been examined on the state of their metabolism. The methodical procedure was determined by measurements of the blood glucose and a 3 hours long glucose tolerance test. Furthermore, questions like the occurrence of diabetics among the relatives, previous births of children weighing more than 4 kg or births of children with malformations were important. In these 9 years 145.196 mothers had been examined. In the following table this examination is classified:
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Maternal diabetes status | Women(overall) | malformation of the child |
| Diabetes before pregnancy | 410 (0,3%) | 25 (6,1%!) |
| Gestational diabetes (pregnancy diabetes) with normal blood glucose level on empty stomach | 2047 | 24 (1,2%) |
| Gestational diabetes (pregnancy diabetes) with increased blood glucose level on empty stomach | 230 | 11 (4,8%!) |
To summarize what is shown in this table, it might be said that the figure of 1,5% of "normal" mothers (not having diabetes mellitus) giving birth to malformated children is relatively high. The percentage of gestational diabetics with increased blood glucose and women already suffering from diabetes before pregnancy who gave birth to children with malformation is even higher (4,8% and 6,1%). Interesting is the fact that women who were treated with insulin and therefore reached a normal blood glucose level had a smaller risk of giving birth to a malformed child than non-diabetics (1,2%).
A second examinational aspect was whether one system or several systems were malformed.
| Kind of malformation | Non-diabetics | Diabetes before pregnancy | Pregnancy diabetes with increased blood glucose on empty stomach | Pregnancy diabetes with normal blood glucose on empty stomach |
| Malformation of one system | 1452 (1%) | 12 (2,9%) | 6 (2,6%) | 15 (0,7%) |
| Several malformations | 308 (0,2%) | 11 (2,7%) | 2 (0,9%) | 4 (0,2%) |
To summarize, it is important to say that every mother should get checked on diabetes at an early stage of her pregnancy. A normal blood glucose on empty stomach should be the aim of every treatment of diabetes during a pregnancy in order to prevent malformations.
source: Diabetes aktuell 2/2003 S.40 (Sheffield, Butler-Koster, Casey, McIntire, Leveno)
Translated by Jella Eifler
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