Changes in insulin therapy during pregnancy.

摘要: Care of the diabetic pregnant woman requires a proper understanding anticipated changes in insulin therapy as guide for establishing and maintaining strict glucose control. Changes daily doses were reviewed 58 pregnancies 50 insulin-dependent women who followed 26 +/- 3 weeks (mean 1 SD) before delivery. By late gestation, was administered on two or three occasions each day using combination regular--and intermediate--acting preparations 55 (95%) pregnancies. Regardless metabolic control duration diabetes, averaged requirements increased twofold from earlier pregnancy. Following initial hospitalization, often decreased increasing almost linearly between 2 9 months gestation. Fluctuations greatest during last trimester. Insulin demand dropped precipitously after delivery two-thirds prepregnancy dose one-third at gestation by third postpartum day. The total average same that pregnancy end first week. Explanations these prescribing are described.