Insulin need fluctuates during first trimester in diabetics

המידע באדיבות מדיקונטקסט
Last Updated: 2001-07-30 14:35:11 EDT (Reuters Health)

By David Douglas

WESTPORT, CT (Reuters Health) – Pregnant women with type 1 diabetes show a reduced need for insulin between weeks 7 and 12 of gestation, researchers report in the July issue of Diabetes Care.

Dr. Lois Jovanovic, of Sansum Medical Research Institute, Santa Barbara, California, and colleagues note that insulin need varies during pregnancy and that there is evidence of a "subtle, transient decline" in the first trimester.

To investigate, the researchers examined data on insulin dosage during this period gathered from a study of 281 pregnant diabetic women.

In pregnancies resulting in live-born full-term singletons, there was a significant (18%) increase in mean weekly dosage between weeks 3 and 7, followed by a significant (9%) decrease in weeks 7 through 12. Certain subgroups of women, including those with a body mass index of more than 27, showed an even greater insulin rise and fall.

Commenting on the findings, Dr. Jovanovic told Reuters Health that "women with type 1 diabetes may experience hypoglycemia in the first trimester and, therefore, careful adjustment of the insulin doses are needed.

"This drop in insulin requirement is a normal response in pregnancy. Previously, it was felt that hypoglycemia in the first trimester was related to pregnancy loss or hyperemesis gravidarum."

Even in the absence of pregnancy-related complications, he concluded, "the insulin requirement drops from the seventh to the twelfth week of gestation. Therefore, clinicians should anticipate an insulin dosage change to prevent hypoglycemia from occurring."

Diabetes Care 2001;24:1130-1136.

-Westport Newsroom 203 319 2700

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