Managing hyperglycaemia during antenatal steroid administration, labour and birth in pregnant women with diabetes

Diabetic Medicine : a Journal of the British Diabetic Association
U DashoraJoint British Diabetes Societies (JBDS) for Inpatient Care

Abstract

Optimal glycaemic control before and during pregnancy improves both maternal and fetal outcomes. This article summarizes the recently published guidelines on the management of glycaemic control in pregnant women with diabetes on obstetric wards and delivery units produced by the Joint British Diabetes Societies for Inpatient Care and available in full at www.diabetes.org.uk/joint-british-diabetes-society and https://abcd.care/joint-british-diabetes-societies-jbds-inpatient-care-group. Hyperglycaemia following steroid administration can be managed by variable rate intravenous insulin infusion (VRIII) or continuous subcutaneous insulin infusion (CSII) in women who are willing and able to safely self-manage insulin dose adjustment. All women with diabetes should have capillary blood glucose (CBG) measured hourly once they are in established labour. Those who are found to be higher than 7 mmol/l on two consecutive occasions should be started on VRIII. If general anaesthesia is used, CBG should be monitored every 30 min in the theatre. Both the VRIII and CSII rate should be reduced by at least 50% once the placenta is delivered. The insulin dose needed after delivery in insulin-treated Type 2 and Type 1 diabetes is usually 25% less ...Continue Reading

References

Feb 1, 1990·Diabetic Medicine : a Journal of the British Diabetic Association·M E LeanH W Sutherland
Apr 1, 1987·American Journal of Perinatology·M MiodovnikJ Holroyde
Aug 13, 1999·Diabetic Medicine : a Journal of the British Diabetic Association·S Carron BrownR Taylor
Jan 10, 2003·Diabetic Medicine : a Journal of the British Diabetic Association·K KaushalR J Young
Aug 1, 1954·Acta Endocrinologica·J PEDERSEN
Mar 11, 2004·Diabetic Medicine : a Journal of the British Diabetic Association·U K Dashora, R Taylor
May 9, 2008·The New England Journal of Medicine·UNKNOWN HAPO Study Cooperative Research GroupDavid A Sacks
Nov 7, 2013·The Journal of Clinical Endocrinology and Metabolism·Ian BlumerYariv Yogev
Mar 21, 2016·Diabetologia·Gernot Desoye, Christopher J Nolan
Mar 29, 2016·Anaesthesia·A ModiG M Hall
Aug 18, 2016·The New England Journal of Medicine·Zoe A StewartHelen R Murphy
Mar 23, 2017·Diabetes Care·Guillermo E Umpierrez, Francisco J Pasquel

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Citations

Sep 6, 2018·Diabetic Medicine : a Journal of the British Diabetic Association·U DashoraE Walden
May 21, 2019·Diabetic Medicine : a Journal of the British Diabetic Association·J M YamamotoUNKNOWN CONCEPTT Collaborative Group*
Sep 19, 2019·Diabetic Medicine : a Journal of the British Diabetic Association·J M YamamotoS L Wood
Aug 29, 2018·Diabetic Medicine : a Journal of the British Diabetic Association·R I G Holt
Jan 17, 2020·Clinical Medicine : Journal of the Royal College of Physicians of London·Ketan DhatariyaGerry Rayman
Dec 4, 2020·Diabetes, Metabolic Syndrome and Obesity : Targets and Therapy·Meichen QianAbdulrahman Al-Mureish
Mar 13, 2021·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Arianne N SweetingGlynis P Ross
Nov 24, 2021·Diabetic Medicine : a Journal of the British Diabetic Association·Umesh DashoraUNKNOWN Joint British Diabetes Societies In Patient group

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