الفهرس 
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Abstract
Pre-gestational diabetes mellitus (PGDM) and maternal hyperglycemia during the time of organogenesis is a known teratogen with detrimental effects on the fetal heart, renal, musculoskeletal, and central nervous systems.
Glycemic control is one of the most important aspects of pre-pregnancy care. Accordingly, this work aimed to compare three different lines of treatment for pregestational type 2 diabetes (metformin, premixed insulin, and basal-bolus regimen drugs) with pregnancy, as regards achieving glycemic control and maternal & fetal outcomes.
This was a prospective observational study that included one hundred matched pregnant females with pregestational diabetes mellitus selected from the outpatient clinic of Alexandria obstetrics and gynecology hospital (El Shatby hospital). All patients were divided into four groups: group (A), including 25 patients who were receiving metformin, group (B), including 25 patients who were receiving premixed insulin, group (C), including 25 patients who were receiving basal-bolus regimen and group (D), including 25 patients subjected to NPH, representing the control group.
In the present study, in comparing clinical features and demographic patterns in PGDM patients based on their methods of therapy, no significant differences were found.
In the current study, the fasting blood sugar during pregnancy in group A and B were statistically significantly higher than in group C and group D (P<0.001 for all). However, no statistically significant difference was reported as regards the average fasting blood sugar between group A and group B (P=1.00), and between group C and group D (P=0.99). These findings indicate that a basal-bolus regimen and NPH insulin were more effective than metformin or premixed insulin as regards regulating the fasting blood sugar level.