This group includes the participation of medical and paramedical services of Endocrinology, Internal Medicine, Dietetic, Psychology, Nursing and Social Work. Treatment: According to current medical standards, the goal of treatment in pregnancy, is to have fasting blood glucose levels less than or equal to 95 mg / dl and postprandial 2 hrs. less than or equal to 120 mg / dl. The global studies to date have concluded that these levels decrease the risk of complications such as fetal macrosomia, and breathing difficulty and improve both fetal and maternal outcome in terms of its chronic complications. However this optimal control, so necessary in pregnancy, particularly in this subgroup of diabetics, it is very difficult to achieve, because as I mentioned before, these patients are very labile in their glucose levels and tend to have tables hyper and hypoglycemia even in the same day. That is why monitoring their blood sugar levels in intensive, by taking glucometrias both before and two hours after each meal becomes very important, for almost the entire pregnancy.
. Self-monitoring also allows us to meet the daily behavior of glucose levels throughout the day, the ability to take intelligent action, appropriate and our custom designed to improve blood glucose levels Improving our eating habits, exercise or While helping the doctor make the best decision on adjustments in insulin doses. The cornerstone of treatment in people with diabetes, with or without pregnancy, the Food Plan, which must be calculated so that the baby be allowed to acquire a weight and proper development without causing uncontrolled levels of glucose in the mother, this is achieved through diet: adequate, balanced, adequate, balanced, and safe (basic laws of supply). As mentioned medical treatment is based There are many schemes insulin, types and ways of delivering insulin, the ideal scheme should take into account: the individual’s height and weight (BMI), degree of uncontrolled metabolic hypoglycemia, feeding schedules, adherence to diet. Personal activities, exercise routines and so on. In our hospital we manage the conduct of NPH insulin + regular insulin or Intermediate (or lispro) 2 or 3 times a day (before meals), with the first we keep insulin levels more or less stable throughout the day, and the second type of inulin avoid postprandial peaks of glucose, which is well known, are responsible for damage to maternal and macrosomia in the baby. Current progress in the way of administering the hormone include the development of insulin infusion pumps which are allowing this administration seems increasingly to what normally happens in a healthy individual, however these devices are still very expensive and not accessible to most population.
Conclusion: Despite advances in self-monitoring and insulin application techniques, and due to the chronicity of type 1 diabetes, it remains very difficult to use and with a high potential maternal and fetal complications which require us to design strategies that improve the development of all pregnancies in this patient population.