Jennifer A Jolley1, Priya V Rajan2, Rita Petersen3, Alex Fong4, Deborah A Wing5. 1. University of Washington Medical Center, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, 1959 NE Pacific Street, Box 356460, Seattle, WA 98195, USA. Electronic address: jajolley@uw.edu. 2. Northwestern University Feinberg School of Medicine, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, NMH/Prentice Women's Hospital Room 05-2175, 250 E Superior, Chicago, IL 60611, USA. Electronic address: priyavrajan@gmail.com. 3. University of California, Irvine Medical Center, Department of Obstetrics and Gynecology, 101 The City Drive, Building 56, Suite 800, Orange, CA 92868, USA. Electronic address: ritapetersen02@gmail.com. 4. Department of Obstetrics and Gynecology, Miller Children's & Women's Hospital Long Beach, 2888 Long Beach Blvd, Suite 400, Long Beach, CA 90806, USA. 5. University of California, Irvine Medical Center, Department of Obstetrics and Gynecology, Divison of Maternal-Fetal Medicine, 101 The City Drive, Building 56, Suite 800, Orange, CA 92868, USA. Electronic address: dwing@uci.edu.
Abstract
OBJECTIVE: To characterize the maternal glycemic response to betamethasone in subjects without diabetes compared to subjects with diabetes. STUDY DESIGN: Blood glucose levels in 22 gravidae without diabetes and 11 gravidae with diabetes were recorded for 48h following betamethasone administration for threatened preterm delivery. Maximum blood glucose value and time to maximum value were compared. Area under the curve calculations were used to express the duration and degree of significant hyperglycemia for individual subjects. These summary measures were then correlated to subject characteristics and laboratory values to determine a risk profile of those subjects without diabetes at risk for significant hyperglycemia. RESULTS: All subjects with diabetes and the majority of those without diabetes had significant hyperglycemia during the study period. Mean maximum blood glucose was higher for those with diabetes (205mg/dL vs. 173mg/dL, p⩽0.01). Mean time to reach the maximum glucose level was similar for both groups. Result of a glucose tolerance test given immediately prior to betamethasone correlated strongly with amount of time spent with hyperglycemia for subjects without diabetes (rho=0.59, p⩽0.01). Morbidly obese subjects spent less time with hyperglycemia than those with lower body mass indices (p=0.03). CONCLUSION: Both subjects with and without diabetes demonstrate significant hyperglycemia after receipt of antenatal betamethasone.
OBJECTIVE: To characterize the maternal glycemic response to betamethasone in subjects without diabetes compared to subjects with diabetes. STUDY DESIGN:Blood glucose levels in 22 gravidae without diabetes and 11 gravidae with diabetes were recorded for 48h following betamethasone administration for threatened preterm delivery. Maximum blood glucose value and time to maximum value were compared. Area under the curve calculations were used to express the duration and degree of significant hyperglycemia for individual subjects. These summary measures were then correlated to subject characteristics and laboratory values to determine a risk profile of those subjects without diabetes at risk for significant hyperglycemia. RESULTS: All subjects with diabetes and the majority of those without diabetes had significant hyperglycemia during the study period. Mean maximum blood glucose was higher for those with diabetes (205mg/dL vs. 173mg/dL, p⩽0.01). Mean time to reach the maximum glucose level was similar for both groups. Result of a glucose tolerance test given immediately prior to betamethasone correlated strongly with amount of time spent with hyperglycemia for subjects without diabetes (rho=0.59, p⩽0.01). Morbidly obese subjects spent less time with hyperglycemia than those with lower body mass indices (p=0.03). CONCLUSION: Both subjects with and without diabetes demonstrate significant hyperglycemia after receipt of antenatal betamethasone.
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