ABSTRACT
This study was undertaken to determine if intensive dietary therapy, home blood glucose monitoring, and the selective use of insulin can be effective in preventing fetal macrosomia. All patients were screened at 24 to 28 weeks' gestation using a modification of O'Sullivan's criteria. The 153 patients diagnosed as gestational diabetics by the study protocol were placed on a 1800 to 2000 Kcal American Diabetes Association diet and taught home glucose monitoring. Insulin therapy was initiated only if blood glucose control was inadequate. There were no significant differences (p greater than 0.05) between the study and reference populations in regard to mean birthweight or the incidence of macrosomia. Since our study criteria for diagnosing gestational diabetes were slightly different from those of the National Diabetes Data Group (NDDG), data from 99 patients meeting the NDDG criteria were analyzed in a similar manner. No significant differences were found between this subgroup and the reference population. Since only 7.2% of our study patients required insulin, we conclude that the incidence of fetal macrosomia in gestational diabetes can be kept equal to that of the general population by a program of intensive dietary therapy and home glucose monitoring, with insulin being used only therapeutically, not prophylactically.
Subject(s)
Diabetes Complications , Fetal Macrosomia/prevention & control , Pregnancy in Diabetics/complications , Adult , Birth Weight/drug effects , Blood Glucose Self-Monitoring , Diabetes Mellitus/diet therapy , Diabetes Mellitus/drug therapy , Diet, Diabetic , Female , Fetal Macrosomia/etiology , Humans , Insulin/therapeutic use , Pregnancy , Pregnancy in Diabetics/diet therapy , Pregnancy in Diabetics/drug therapyABSTRACT
Three viral agents isolated from nasal exudate of Illinois cattle affected with respiratory disease were studied. The agents were classified as picornaviruses on the basis of their resistance to ether, stability at pH 3.0, and morphological characteristics. Magnesium chloride at 1 M concentration protected the viruses from reduction of infectivity by exposure to 50 degrees C for one and two hours. None of the viruses was pathogenic for mice. Replication of one of the viruses was not affected by the DNA inhibitor, 5 fluorodeoxyuridine. That two of the agents were closely related serologically was demonstrated by serum neutralization tests. As revealed by electron microscopy, viral particles were spherical or hexagonal and ranged in size from 280 A to 290 A.
