PMID- 30152588
OWN - NLM
STAT- MEDLINE
DCOM- 20190111
LR  - 20190111
IS  - 1464-5491 (Electronic)
IS  - 0742-3071 (Linking)
VI  - 35
IP  - 8
DP  - 2018 Aug
TI  - Managing hyperglycaemia during antenatal steroid administration, labour and birth
      in pregnant women with diabetes.
PG  - 1005-1010
LID - 10.1111/dme.13674 [doi]
AB  - Optimal glycaemic control before and during pregnancy improves both maternal and 
      fetal outcomes. This article summarizes the recently published guidelines on the 
      management of glycaemic control in pregnant women with diabetes on obstetric
      wards and delivery units produced by the Joint British Diabetes Societies for
      Inpatient Care and available in full at
      www.diabetes.org.uk/joint-british-diabetes-society and
      https://abcd.care/joint-british-diabetes-societies-jbds-inpatient-care-group.
      Hyperglycaemia following steroid administration can be managed by variable rate
      intravenous insulin infusion (VRIII) or continuous subcutaneous insulin infusion 
      (CSII) in women who are willing and able to safely self-manage insulin dose
      adjustment. All women with diabetes should have capillary blood glucose (CBG)
      measured hourly once they are in established labour. Those who are found to be
      higher than 7 mmol/l on two consecutive occasions should be started on VRIII. If 
      general anaesthesia is used, CBG should be monitored every 30 min in the theatre.
      Both the VRIII and CSII rate should be reduced by at least 50% once the placenta 
      is delivered. The insulin dose needed after delivery in insulin-treated Type 2
      and Type 1 diabetes is usually 25% less than the doses needed at the end of first
      trimester. Additional snacks may be needed after delivery especially if
      breastfeeding. Stop all anti-diabetes medications after delivery in gestational
      diabetes. Continue to monitor CBG before and 1 h after meals for up to 24 h after
      delivery to pick up any pre-existing diabetes or new-onset diabetes in pregnancy.
      Women with Type 2 diabetes on oral treatment can continue to take metformin after
      birth.
CI  - (c) 2018 Diabetes UK.
FAU - Dashora, U
AU  - Dashora U
AD  - Conquest Hospital, St Leonards on Sea, UK.
FAU - Murphy, H R
AU  - Murphy HR
AUID- ORCID: http://orcid.org/0000-0001-6876-8727
AD  - Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
AD  - Norwich Medical School, University of East Anglia, Norwich, UK.
FAU - Temple, R C
AU  - Temple RC
AD  - Norfolk and Norwich University Hospital, Norwich, UK.
FAU - Stanley, K P
AU  - Stanley KP
AD  - Norfolk and Norwich University Hospital, Norwich, UK.
FAU - Castro, E
AU  - Castro E
AD  - East Sussex Healthcare NHS Trust, St Leonards on Sea, UK.
FAU - George, S
AU  - George S
AD  - East and North Hertfordshire NHS Trust, Stevenage, UK.
FAU - Dhatariya, K
AU  - Dhatariya K
AUID- ORCID: http://orcid.org/0000-0003-3619-9579
AD  - Norwich Medical School, University of East Anglia, Norwich, UK.
AD  - Norfolk and Norwich University Hospital, Norwich, UK.
FAU - Haq, M
AU  - Haq M
AD  - Maidstone and Tunbridge Wells NHS Trust, Tunbridge Wells, UK.
FAU - Sampson, M
AU  - Sampson M
AUID- ORCID: http://orcid.org/0000-0002-1433-2319
AD  - Norwich Medical School, University of East Anglia, Norwich, UK.
AD  - Norfolk and Norwich University Hospital, Norwich, UK.
CN  - Joint British Diabetes Societies (JBDS) for Inpatient Care
LA  - eng
GR  - CDF-2013-06-035/Department of Health/United Kingdom
PT  - Journal Article
PT  - Practice Guideline
PL  - England
TA  - Diabet Med
JT  - Diabetic medicine : a journal of the British Diabetic Association
JID - 8500858
RN  - 0 (Glucocorticoids)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
SB  - IM
MH  - Administration, Intravenous
MH  - Adult
MH  - Delivery, Obstetric/methods/standards
MH  - Diabetes Mellitus, Type 1/blood/complications/therapy
MH  - Diabetes Mellitus, Type 2/blood/complications/therapy
MH  - Female
MH  - Fetal Organ Maturity/drug effects
MH  - Glucocorticoids/*therapeutic use
MH  - Humans
MH  - Hyperglycemia/blood/*therapy
MH  - Hypoglycemic Agents/administration & dosage
MH  - Insulin/administration & dosage
MH  - Insulin Infusion Systems
MH  - *Labor, Obstetric/drug effects/physiology
MH  - *Parturition/drug effects/physiology
MH  - Pregnancy
MH  - Pregnancy in Diabetics/blood/*therapy
MH  - Prenatal Care/*methods
IR  - Allan B
FIR - Allan, B
IR  - Flanagan D
FIR - Flanagan, D
IR  - Gregory R
FIR - Gregory, R
IR  - James J
FIR - James, J
IR  - Jones D
FIR - Jones, D
IR  - Lewis A
FIR - Lewis, A
IR  - De P
FIR - De, P
IR  - Rayman G
FIR - Rayman, G
IR  - Ritchie S
FIR - Ritchie, S
IR  - Roberts A
FIR - Roberts, A
IR  - Stanisstreet D
FIR - Stanisstreet, D
IR  - Valabhji J
FIR - Valabhji, J
IR  - Walden E
FIR - Walden, E
IR  - Winocour P
FIR - Winocour, P
EDAT- 2018/08/29 06:00
MHDA- 2019/01/12 06:00
CRDT- 2018/08/29 06:00
PHST- 2018/05/11 00:00 [accepted]
PHST- 2018/08/29 06:00 [entrez]
PHST- 2018/08/29 06:00 [pubmed]
PHST- 2019/01/12 06:00 [medline]
AID - 10.1111/dme.13674 [doi]
PST - ppublish
SO  - Diabet Med. 2018 Aug;35(8):1005-1010. doi: 10.1111/dme.13674.