Investigating on the changes of blood glucose levels and methods of treatment in pregnant women with gestational diabetes mellitus after using antenatal corticosteroid therapy

Abstract

Background: Studies on the changes of blood glucose levels in pregnant women having gestational diabetes mellitus treated with antenatal corticoid to prevent neonatal respiratory distress syndrome have been carried out around the world.

Study objectives: 1-To investigate clinical features and changes of glucose levels in gestational diabetes mellitus patients treated with antenatal corticoid, 2-To investigate on methods of treatment for this patients.

Materials and methods: 1-Objects: 50 gestational diabetic mellitus patients admitted and treated with antenatal corticoid. 2-Methods: longitudinal study.

Results: Blood glucose changes in follow up on 7 days after using antenatal corticoid: prepandial capillary blood glucose was greater than 5,3mmol/l in over 80% of patients on days 2 and 3 and remained elevated in over 45% on day 7, two hour post-prandial capillary blood glucose was greater than 6.7mmol/l in 77.4% - 82,2% on days 1 - 3 and in over 51% patients on day 4-7; the mean glucose variability levels were 0.75-1.79 mmol/l; the incidence of hypoglycemic episode was 0.74%. 2- After corticoid injectión, the number of patients treated with insulin increased, in whom treated with insulin before corticoid therapy, 52% of them was doubled in the insulin dose, the highest demand for insulin increasing in the third day after injection; there was a positive correlation between total insulin dose and HbA1c level on admission.

Conclusions: 1-Women with gestational diabetes mellitus after using antenatal corticoid would increase their blood glucose levels, especially on day 2, 3 and decrease gradually until day 7 with the mean glucose variability was 0.75 – 1.79 mmol/l; 2- Almost patients with gestational diabetes after antenatal corticoid therapy needed insulin or doubled the dose to control blood glucose level, there was a positive correlation between the total insulin dose and HbA1c level on admission.