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Ginecología y Obstetricia de México

Federación Mexicana de Ginecología y Obstetricia, A.C.
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2011, Number 09

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Ginecol Obstet Mex 2011; 79 (09)

Effect of betamethasone in blood glucose levels in pregnant diabetic women at risk of preterm birth

Ramírez-Torres MA, Pérez-Monter SE, Espino SS, Ibargüengoitia-Ochoa F
Full text How to cite this article

Language: Spanish
References: 18
Page: 569-575
PDF size: 173.34 Kb.


Key words:

Betamethasone, diabetic pregnant glycemia, risk of preterm birth.

ABSTRACT

Background: The bethametasone (BTM) induced hyperglycemia is not adequately known and managed in diabetic pregnant women.
Objective: To compare the betamethasone – induced hyperglycemia in pregnant women either healthy or with gestational or type 2 diabetes mellitus (diabetes mellitus).
Material and methods: Forty volunteer pregnant women at risk of premature rupture of membranes who received betamethasone (12 mg i.m. every 24 hours, 2 doses) were divided in four groups (10 women each): G1, healthy; G2, Diet treated diabetes mellitus; G3, Diet plus insulin treated diabetes mellitus; G4, type 2 diabetes mellitus treated with diet (n=6) or diet and insulin (n=4). Pre (p) and 2h-postprandial (pp) capillary blood glucose was measured throughout the day during 5 days of hospitalization. Student’t test for independent and dependent samples was used.
Results: G1 had no significant changes in p or pp glucose. In G2 four women required de novo insulin administration while insulin dose was increased 39 to 112% and 26 to 64% in all women in G3 and G4, respectively to maintain p and pp glucose levels ‹ 95 mg/dL and ‹ 120 mg/dL, respectively. The greatest changes occurred between days 2 to 4after betamethasone.
Conclusion: Betamethasone-induced hyperglycemia was greater in insulin treated women with gestational or type 2 diabetes and should not be administrated on an out-patient basis.


REFERENCES

  1. Vadillo OF, Beltrán MJ, Zaga CV. Intrauterine infection and preterm birth. Rev Invest Clín 2004;56:93-102.

  2. Michael WeindLing A. Offspring of diabetic pregnancy: shortterm outcomes. Semin Fetal Neonatal Med 2009;14:111-118.

  3. Roberts D, Daziel S. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk for preterm birth. Cochrane Database of Systematic Reviews 2006; Issue 3, Art. No.: CD004454.DOI:10.1002/14651858. CD004454.pub2

  4. Miracle X, Di Renzo GC, Stark A, Fanaroff A, Carbonell-Estrany X, Saling E Coordinators of WAPM prematurity working group. J Perinat Med 2008;36:191-196.

  5. Schumacher A, Sidor J, Bühling KJ. Continuous glucose monitoring using the glucose sensor CGMS in metabolically normal pregnant women during betamethasone therapy for fetal respiratory distress syndrome [in German]. Z Geburtshilfe Neonatol 2006;210:184-190.

  6. Shelton SD, Boggess KA, Smith T, Herbert WN. Effect of betamethasone on maternal glucose. J Matern Fetal Neonatal Med 2002;12:191-195.

  7. Neiger R, Star J. Hyperglycemia in non-diabetic gravidas receiving steroids for induction of fetal lung maturation. J Maternal-Fetal Inv 1997;7:89-91.

  8. Star J, Hogan J, Sosa ME, Carpenter MW. Glucocorticoidassociated maternal hyperglycemia: a randomized trial of insulin prophylaxis. Matern Fetal Med 2000;9:273-277.

  9. Mathiesen ER, Christensen AB, Hellmuth E, Hornnes P, et al. Insulin dose during glucocorticoid treatment for fetal lung maturation in diabetic pregnancy: test of an algorithm [correction of an algorithm]. Acta Obstet Gynecol Scand 2002;81:835-839.

  10. Kaushal K, Gibson JM, Railton A, Hounsome B, et al. A protocol for improved glycaemic control following corticosteroid therapy in diabetic pregnancies. Diabetic Med 2003;20:73-75.

  11. Bedalov A, Balasubramanyam A. Glucocorticoid-induced ketoacidosis in gestational diabetes: sequel of acute treatment of preterm labor. A case report. Diabetes Care 1997;20:922-924.

  12. Arroyo P, Casanueva E, Reynoso M. Peso ideal para la estatura y edad gestacional. Tablas de referencia. Ginecol Obstet Mex 1985;53:227-230.

  13. Normas y procedimientos en Ginecología y Obstetricia. Instituto Nacional de Perinatología. Mexico, DF, 2003.

  14. Antonow-Schlorke I, Schwab M, Li C, Nathanielsz PW. Glucocorticoid exposure at the dose used clinically alters cytoskeletal proteins and presynaptic terminals in the fetal baboon brain. J Physiol 2003;547 (Pt 1):117-123.

  15. Sloboda diabetes mellitus, Moss TJ, Li S, Doherty DA, Nitsos I, Challis JR, Newnham JP. Hepatic glucose regulation and metabolism in adult sheep: effects of prenatal betamethasone. Am J Physiol Endocrinol Metab 2005;289:E721-E728.

  16. Das UG, Schroeder RE, Hay WW Jr, Devaskar SU. Timedependent and tissue-specific effects of circulating glucose on fetal ovien glucose transporters. Am J Physiol 1999;276 (3 Pt 2):R309-R317

  17. Schäffer L, Luzi F, Burkhardt T, Rauh M, Beinder E. Antenatal betamethasone administration alters stress physiology in healthy neonates. Obstet Gynecol 2009;113:1082-1088.

  18. Koivisto M, Peltoniemi OM, Saarela T, Tammela O, et al. Blood glucose level in preterm infants after antenatal exposure to glucocorticoid. Acta Paediatr 2007;96:664-668.




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Ginecol Obstet Mex. 2011;79