Gestational diabetes mellitus: Insulinic management

被引:18
作者
Magon N. [1 ]
Seshiah V. [2 ]
机构
[1] Department of Obstetrics and Gynecology, Air Force Hospital, Jorhat, Assam
[2] Dr. V. Seshiah Diabetes Research Institute, Dr. Balaji Diabetes Care Centre, Chennai, Tamil Nadu
关键词
Aspart; Detemir; Diabetes; GDM; Insulin; Lispro; Pregnancy;
D O I
10.1007/s13224-014-0525-4
中图分类号
学科分类号
摘要
Diabetic pregnancies have attendant risks. Adverse fetal, neonatal, and maternal outcomes in a diabetic pregnancy can be avoided by optimum glycemic control. Most pregnancies with GDM can be managed with non-insulinic management, which includes medical nutrition therapy. However, many necessitate concomitant insulinic management. The new insulin analogs present undoubted advantages in reducing the risk of hypoglycemia, mainly during the night, and in promoting a more physiologic glycemic profile in pregnant women with diabetes. Rapid-acting insulin analogs seem to be safe and efficient in reducing postprandial glucose levels more proficiently than regular human insulin, with less hypoglycemia. The long-acting insulin analogs do not have a pronounced peak effect as NPH insulin, and cause less hypoglycemia, mainly during the night. The review focuses on glycemic goals in pregnancy, insulinic management of GDM, and posology of insulin and its analogs. Clear understanding of the insulinic management of GDM is essential for women's health care providers to provide comprehensive care to women whose pregnancies are complicated with diabetes and rechristen the diabetic capital of the world" to the "diabetic care capital of the world." © Federation of Obstetric & Gynecological Societies of India 2014."
引用
收藏
页码:82 / 90
页数:8
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