Pg 102-107

Great strides were made during the last century in the management of diabetes in pregnancy. Before the discovery of insulin in 1921 the outlook for the diabetic mother and her fetus was abysmal. With the advent of insulin, an emphasis on a team approach to care, improved methods of fetal surveillance, and a focus on metabolic normalisation brought about by intensive insulin regimens and home glucose monitoring, the outlook for both the diabetic mother and her offspring has improved dramatically, approaching that of the nondiabetic pregnancy. However, this success story, which is the experience of many developed countries, is not shared to any great extent in sub-Saharan Africa, where the resources for diabetes management are often lacking, resulting in a situation reminiscent of the pre-insulin era. Reports from this region on the management of diabetes in pregnancy are few, the numbers are small, and the perinatal mortality figures are high.