Twinning project: Israel and Georgia - the birth of a Diabetes-in-Pregnancy Centre in Georgia

Summary Aims To determine the effectiveness of a joint Israeli–Georgian twinning project aimed at introducing modern methods of perinatal care to Georgian women with pregestational diabetes mellitus. Methods A Diabetes‐in‐Pregnancy Centre was established in Georgia (in the former USSR). Thirty‐two women with Type 1 diabetes mellitus participated in the first stage of the study (January 1997–June 1998). All were maintained under strict metabolic surveillance starting at least three months prior to conception and were given organized instruction in methods of self‐monitoring of glucose levels, insulin dose adjustment, dietary management and close fetal surveillance throughout pregnancy. A second stage of the project was started in January 1998 and aimed at the diagnosis of gestational diabetes mellitus (GDM). Results Of the 32 women, 20 had had a total of 44 prior pregnancies without proper perinatal care (1990–96); only five (11.3%) ended in the birth of a healthy infant. On entry to the study, all 32 patients had unsatisfactory metabolic indices. HbA1c levels decreased significantly from the pre‐conception period (P