Review CURRENT CONCEPTS IN MANAGEMENT OF DIABETES MELLITUS IN PREGNANCY: ROLE OF INSULIN PUMPS AND ANALOGUES

Glucose intolerance may develop in the mother before or during pregnancy. In pre gestational diabetes, the embryo is exposed to a hostile environment from the moment of conception. Gestational diabetes (diabetes that develops during pregnancy) may cause macrosomia, childhood obesity and impaired glucose tolerance, but not congenital defects. Infants of gestational diabetic mothers are at the risk of complications related to maternal glucose concentration and presence of anti insulin antibodies. The availability of human insulin has improved fetal outcome by achieving good metabolic control and it does not produce anti insulin antibodies. Continuous subcutaneous insulin infusion (CSII) by insulin pumps can be used in those patients who cannot achieve good glycemic control with multiple injections. The experience with CSII during pregnancy is still limited. Insulin analogues are also being tried successfully.