A method for maintaining normoglycemia during labour and delivery in insulin-dependent diabetic women.
The effectiveness of combining the subcutaneous administration of short- and intermediate-acting insulin with the intravenous infusion of glucose in maintaining normoglycemia during labour and delivery in insulin-dependent diabetic women was tested. Fifty women were given intermediate-acting insulin twice daily in doses that were fractions of their usual dose, based on the projected duration of labour. In addition, they were given regular (i.e., short-acting) insulin every 6 hours, the dose being 1% of their total daily insulin dose for every increase of 10 mg/dl above 100 mg/dl (5.6 mmol/l) in the plasma glucose level 1 hour previously; the levels were measured every 3 hours. All the patients were fasting and received a basal intravenous infusion of 6 g/h of glucose; the rate of infusion was increased by 1 g/h for every decrease of 10 mg/dl in the plasma glucose level below 100 mg/dl. The mean plasma glucose levels (+/- standard deviation) were 90 +/- 46 mg/dl after 3 hours of labour, 92 +/- 35 mg/dl after 6 hours, 97 +/- 49 mg/dl after 9 hours and 107 +/- 65 mg/dl after 12 hours. With only one exception, in a premature infant, the 5-minute Apgar scores were identical to those of the infants of nondiabetic women.
D001034:Apgar Score; D001786:Blood Glucose / Q000032:analysis; D036861:Delivery, Obstetric; D005260:Female; D005947:Glucose / Q000008:administration & dosage*; D006801:Humans; D007231:Infant, Newborn; D007263:Infusions, Parenteral; D007279:Injections, Subcutaneous; D007328:Insulin / Q000008:administration & dosage*; D007743:Labor, Obstetric; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000188:drug therapy*
D001786:Blood Glucose; D007328:Insulin; D005947:Glucose