Diabetes is a reduction in the ability of the body to take glucose in the blood and get it into cells where it can be used. Pregnancy is called "diabetogenic" (hindering or helping to hinder the movement of glucose into cells), due to maternal hormones:

• Human chorionic somatomammotrophin (aka human placental lactogen) (HPL) is made by the placenta in increasing amounts as pregnancy progresses, and it acts as an anti-insulin substance.

• Estrogen and progesterone also increase, with similar effects

Despite these effects, most pregnant women do not become glucose intolerant - there is sufficient extra capacity of the pancreas to overcome these effects. However, about 4 percent of pregnant women do show a high blood sugar as pregnancy progresses. This is called gestational diabetes, although the term "diabetes" does not mean that it is a permanent condition - in fact, most of these women will not be diabetic after the baby is born and the placenta is delivered.

Detection and management of glucose intolerance in pregnancy

• General management plan for the diabetic gravida

• White classification of diabetes

• Effects of glucose intolerance in pregnancy

• Screening for glucose intolerance in pregnancy

• Management of gestational diabetes/gestational glucose intolerance

• Management of the pre-gestational or insulin-requiring gestational diabetic pregnant woman

• Delivery of the insulin-requiring diabetic gravida

• Diabetic Ketoacidosis