Insulin and glucose requirements during the first stage of labor in insulin-dependent diabetic women.
Studies utilizing glucose-controlled insulin infusion systems were undertaken to more accurately define the glucose and insulin requirements during the first stage of labor induced by oxytocin in 12 insulin-dependent diabetic women in whom normoglycemia had been maintained before delivery. Insulin requirements decreased to zero during active stage 1 labor, while the glucose infusion rate necessary to maintain a blood glucose level of 70 to 90 mg/dl (or 3.9 to 5.0 mmol/liter) was constant at 2.55 mg/kg per minute. The findings were confirmed in 40 additional studies of oxytocin-induced labor. Studies of six women undergoing spontaneous labor and one nonpregnant woman receiving oxytocin confirmed that the decrement in the insulin requirement during stage 1 labor was not influenced by oxytocin infusion. The changes occurred regardless of whether epidural anesthesia was employed. Insulin requirements returned during the second stage of labor. Active stage 1 labor in diabetic women thus appears to be associated with a predictable decrease in the need for insulin and a constant glucose requirement.
D001786:Blood Glucose / Q000032:analysis; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D005260:Female; D005947:Glucose / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D007328:Insulin / Q000008:administration & dosage*; D007332:Insulin Infusion Systems; D007747:Labor Stage, First; D007751:Labor, Induced; D007743:Labor, Obstetric; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000188:drug therapy*
D001786:Blood Glucose; D007328:Insulin; D005947:Glucose