The clinical analysis of hyperglycemic controls with four times daily administration of insulin on diabetes in pregnancy

Lee, Ho; Kim, So Young; Lee, Jin Kyo; Lee, Eun Taek; Jang, Jin Ho; Lee, Jeong Hun; Park, Jee Hyun; Hwang, Sung Ook; Song, Eun Seop; Koh, Seung Kwon; Im, Moon Whan; Lee, Woo Young

Abstract

OBJECTIVE
To determine whether administrating insulin four times daily, compared to 1-3 times daily, improves maternal and perinatal outcomes of diabetes.
METHODS
From August 1998 to April 2004, the 14 pregnant diabetic women were treated with four times daily administration of NPH and insulin-lispro and 15 pregnant diabetic women were treated with 1-3 times daily administration of Mixtard (30% RI, 70% NPH) or NPH. We compared the maternal and fetal complications between two groups. The goals for therapy are to achieve and maintain normoglycemia (premeal whole blood capillary glucose levels of less than 90 mg/dL and 1-hour after-meal levels of less than 120 mg/dL).
RESULTS
The pregnant diabetic women who were treated with four times daily administration of NPH and Insulin lispro, instead of 1-3 times daily administration of Mixtard or NPH, resulted in better maternal and fetal outcome. But there was no significant difference between two groups statistically.
CONCLUSION
This study reveals that this four times daily administration of NPH and insulin-lispro protocol achieved the glucose target level without maternal hypoglycemic events and helped to reduce the perinatal complications in pregnant diabetic women.