TITLE:
The effect of antenatal corticosteroids on maternal serum glucose in women with diabetes
AUTHORS:
Allison Kreiner, Karen Gil, Justin Lavin
KEYWORDS:
Gestational Diabetes; Fetal Lung Maturity; Glucose Regulation
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.2 No.2,
June
27,
2012
ABSTRACT: Objective: To evaluate changes in serum glucose values following administration of corticosteroids in women with gestational (GDM) or pre-gestational diabetes (PGDM). Method: Patients with diagnoses of pregnancy and GDM or PGDM from 2006-2009 who received corticosteroids for enhancement of fetal pulmonary maturity as an inpatient were identified following IRB approval. Fasting (FSG) and two hour post prandial serum (PPSG) glucose levels, and oral anti-hyperglycemic agents and insulin given were recorded. Day 1 (D1) was the day the first dose of corticosteroid was administered. The percentage of women with FSG > 95 mg/dL and the percentage with at least one PPSG > 120 mg/dL during each day were calculated. Data were analyzed utilizing SPSS v15. Results: Fifty-five patients met the study criteria. FSG was greater than 95 mg/dL in over 90% of women on Days 2 and 3 and remained elevated in 51% on Day 4. At least one PPSG was greater than 120 mg/dL in 81% - 98% on Days 1 - 3, and in over 60% on Days 4 - 6. The majority of women taking insulin received increases in doses that were less than double their regular dose (26 out of 33); the others received higher doses. Three of 6 patients who began the study taking glyburide were started on insulin. Of the 19 who began the study with diet controlled GDM, 11 were started on medication. Conclusion: Women with GDM or PGDM who are administered antenatal corticosteroids will experience prolonged serum glucose levels above the range associated with optimal pregnancy outcome.