Endocrine Abstracts

Administration of antenatal steroids for foetal lung maturity is considered for all women at risk for preterm birth before 37 weeks. Administration of two doses of betamethasone 12 mg intramuscularly, 24 hours apart may result in a deterioration of glycaemic control for 2–3 days in patients with gestational diabetes (GDM), thereby potentially affecting foetal wellbeing. Current practice was noted to be inconsistent, and a protocol was drawn up for variable rate insulin infusion for all GDM patients requiring betamethasone. We sought to review effectiveness of the protocol to achieve better glycaemic control in those requiring betamethasone injections. Retrospective data was collected from chart review of 17 GDM patient who were treated with VRIII after betamethasone injections and subsequently monitored for up to 24 hours after last dose of betamethasone and glycaemic control was compared with the data of 17 GDM patients from before implementation of VRIII protocol Hourly glucose was monitored. There was no difference in glucose values in the first 14 hours. From 14 to 32 hours, mean glucose ± sd mmol/l were 7.8 ± 1.0 pre protocol, and 6.2 ± 0.4 post implementation of protocol (P = 0.002), We conclude that VRIII in GDM patients requiring betamethasone is effective in maintaining target glucose of 4 to 7 mmol/l.