Abstract

GLYCEMIC CONTROL WITH DIFFERENT TYPES OF INSULIN IN THE MANAGEMENT OF GESTATIONAL DIABETES MELLITUS

Ambarisha Bhandiwad and *Surakshith L Gowda

Abstract

Background: Gestational diabetes mellitus is one of the most common medical complications of pregnancy. It has been demonstrated that good metabolic control maintained throughout pregnancy can reduce maternal and fetal complications in diabetes and insulin is considered as gold standard for the management of GDM. Aim: To compare the efficacy of regular insulin with rapid acting insulin in combination with intermediate acting insulin in the management of GDM. Methods: It is a retrospective review analysis of two groups of patients, in whom one group of patients was started with regular insulin and another group of patients on rapid acting insulin with one dose of isophane insulin at bed time and results were compared in terms of mean glucose values, neonatal birth weight, amniotic fluid index, period of gestation and neonatal hypoglycemia. Results: The mean glucose value in rapid acting insulin group was 108.2mg/dl whereas it was 116.4mg/dl with regular insulin group. The mean AFI and period of gestation in rapid acting group was 10.6 cms and 38 weeks 5 days respectively in comparison with 13 cms and 37 weeks 3 days for regular insulin group. 60% of the babies in regular insulin group had neonatal hypoglycemia and it was 30% for rapid acting group. Conclusion: It was found that rapid acting insulin along with isophane insulin (NPH) at bed time had better glycemic control in comparison with only regular insulin.

Keywords: Gestational Diabetes, regular insulin, rapid acting insulin, isophane insulin, pregnancy.