Normalization of blood glucose in insulin-dependent diabetic pregnancies and the risks of hypoglycemia: a therapeutic dilemma.
Intensive insulin therapy delays the onset and progression of microvascular complications in insulin-dependent diabetes mellitus (IDDM). Such therapy, however, is associated with an increased risk of potentially life-threatening hypoglycemia due to the loss of normal counterregulatory hormonal responses to hypoglycemia and to the syndrome of hypoglycemia unawareness. Current standards for glycemic control during pregnancy in IDDM women require intensive insulin therapy to optimize pregnancy outcome. Therefore, obstetricians and gynecologists providing prenatal care for women with IDDM should be aware that intensive insulin therapy predisposes these patients to the significant risks of severe hypoglycemia. It often becomes necessary to individualize the optimal balance between glycemic control during pregnancy and the risks of hypoglycemia.
Rosenn
B
B
Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Ohio 45267-0526.
Siddiqi
T A
TA
Miodovnik
M
M
D001786:Blood Glucose / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D005314:Embryonic and Fetal Development / Q000187:drug effects; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced*; D007328:Insulin / Q000009:adverse effects* / Q000627:therapeutic use; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D012307:Risk Factors
D001786:Blood Glucose; D007328:Insulin