Razi Journal of Medical Sciences

Marked metabolic derangement have already been documented in normal pregnancy such as decrease of serum glucose and aminoacids, increase free fatty acids, triglyceride, ketons and insulin secretion, however in gestational diabetes the high gluc(Jse which is facilitated by placental transfer may cause hyperinsulinemia in fetus thus rendering them susceptible to macrosomia and subsequent perinatal difficulties.

We prospectively followed 117 patients from first trimester period. These patients randomly divided into two groups: Group one (59 cases) was placed on specific diet and Second group (58 cases) received monitored diet plus insulin.

Then we measured maternal weight gains, neonatal birth weights, meteme! fasting and postprandial blood sugar at specific intervals,

Initial first trimester maternal weights, gained weights and birth weights were 67.03±3.60 kg and 15.76±3.58 kg and 4.26±0.29 kg for the first group and 65.82±5.25 and 12.68±4.78kg~nd 3.48±0.78 kg for the second group. In 60 normal pregnants these measurement was 56.79±5.41 kg and 12.43±3.20 kg and 3.35±0.36 kg Cesarean section indicated in 71.18 % and 26.2% and 21.66% in two management and control groups respectively (P<0.05).

Addition of insulin seems to protect excess maternal and newborn weight gainand reduce the surgical procedure.