دورية أكاديمية
Peripartum management of Glycemia in women with Type 1 diabetes
| العنوان: | Peripartum management of Glycemia in women with Type 1 diabetes |
|---|---|
| المؤلفون: | Achong, Naomi, Duncan, Emma, McIntyre, David, Callaway, Leonie |
| المصدر: | Diabetes Care |
| بيانات النشر: | American Diabetes Association Inc. |
| سنة النشر: | 2014 |
| المجموعة: | Queensland University of Technology: QUT ePrints |
| مصطلحات موضوعية: | Australia, Blood Glucose, Diabetes Mellitus, Humans, Peripartum Period, Pregnancy in Diabetics, Prospective Studies, Retrospective Studies, Type 1, adult, aged, article, blood, body mass, continuous infusion, correlation analysis, creatinine, creatinine blood level, delivery, drug withdrawal, female, glucose blood level, human, hypoglycemia, insulin, insulin dependent diabetes mellitus, long acting insulin, major clinical study, metabolism, non insulin dependent diabetes mellitus |
| الوصف: | OBJECTIVE We aimed to 1) describe the peripartum management of type 1 diabetes at an Australian teaching hospital and 2) discuss factors influencing the apparent transient insulin independence postpartum. RESEARCH DESIGN AND METHODS We conducted a retrospective review of women with type 1 diabetes delivering singleton pregnancies from 2005 to 2010. Information was collected regarding demographics, medical history, peripartum management and outcome, and breast-feeding. To detect a difference in time to first postpartum blood glucose level (BGL) >8 mmol/L between women with an early (<4 h) and late (>12 h) requirement for insulin postpartum, with a power of 80% and a type 1 error of 0.05, at least 24 patients were required. RESULTS An intravenous insulin infusion was commenced in almost 95% of women. Univariate analysis showed that increased BMI at term, lower creatinine at term, longer duration from last dose of long- or intermediate-acting insulin, and discontinuation of an insulin infusion postpartum were associated with a shorter time to first requirement of insulin postpartum (P = 0.005, 0.026, 0.026, and <0.001, respectively). There was a correlation between higher doses of insulin commenced postpartum and number of out-of-range BGLs (r[36] = 0.358, P = 0.030) and hypoglycemia (r[36] = 0.434, P = 0.007). Almost 60% had at least one BGL <3.5 mmol/L between delivery and discharge. CONCLUSIONS Changes in the pharmacodynamic profile of insulin may contribute to the transient insulin independence sometimes observed postpartum in type 1 diabetes. A dose of 50–60% of the prepregnancy insulin requirement resulted in the lowest rate of hypoglycemia and glucose excursions. These results require validation in a larger, prospective study. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | unknown |
| العلاقة: | https://eprints.qut.edu.au/94204/1/364.full.pdfTest; Achong, Naomi, Duncan, Emma, McIntyre, David, & Callaway, Leonie (2014) Peripartum management of Glycemia in women with Type 1 diabetes. Diabetes Care, 37(2), pp. 364-371.; https://eprints.qut.edu.au/94204Test/; Faculty of Health; Institute of Health and Biomedical Innovation |
| الإتاحة: | https://doi.org/10.2337/dc13-1348Test https://eprints.qut.edu.au/94204Test/ |
| حقوق: | free_to_read ; http://creativecommons.org/licenses/by-nc-nd/2.5Test/ ; Consult author(s) regarding copyright matters ; This work is covered by copyright. Unless the document is being made available under a Creative Commons Licence, you must assume that re-use is limited to personal use and that permission from the copyright owner must be obtained for all other uses. If the document is available under a Creative Commons License (or other specified license) then refer to the Licence for details of permitted re-use. It is a condition of access that users recognise and abide by the legal requirements associated with these rights. If you believe that this work infringes copyright please provide details by email to qut.copyright@qut.edu.au |
| رقم الانضمام: | edsbas.C11E1D1A |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |