ABSTRACT
@#Abstract Maternal hyperglycemia during the peripartum period is highly correlated with fetal hyperinsulinemia and consequent neonatal hypoglycemia. Liberal use of intravenous glucose therapy prior to delivery can potentially cause maternal hyperglycemia, therefore, it is prudent to implement all preventive measures. This study aims to determine the occurrence of neonatal hypoglycemia with intravenous glucose therapy prior to delivery in maternal diabetes mellitus. This was a retrospective cohort study of neonates born from diabetic mothers at the University of Santo Tomas Hospital Clinical and Private Divisions from January 1, 2013 to December 15, 2017. Clinical information gathered was divided into maternal and neonatal characteristics. Maternal intravenous fl uid use, rate, and duration were noted; maternal and neonatal blood glucose results were obtained. There were 109 infants of diabetic mothers, of which 105 were delivered as singleton and 4 from twin pregnancies. Neonatal hypoglycemia was present in 14.68%. Comparing the risk factors, there was a higher amount of glucose infused to the mothers whose offspring developed hypoglycemia compared to those without hypoglycemia. Statistically, this did not demonstrate a signifi cant difference. The rate of glucose infusion and frequency of maternal insulin use were similar between the groups. Linear correlation was not evident when the total glucose infused and the rate of intravenous glucose infusion was compared to the neonatal glucose in the fi rst hour of life. Based on this study, routine administration of glucose-containing intravenous fl uid did not infl uence the incidence of neonatal hypoglycemia. It is recommended that further prospective studies be conducted.
Subject(s)
Diabetes, GestationalABSTRACT
Background @#Prediabetes is an intermediate stage prior to development of diabetes mellitus. Preimpaired glucose tolerance state represents an early stage in the pathogenesis of diabetes wherein the normal glucose is attained by compensated hyperinsulinemia. Glycosylated hemoglobin is used in diagnosis and monitoring of diabetes but has not been explored in pre-IGT state. The objective of this study is to compare the 2-hour blood glucose, 2-hour insulin level, and HbA1c between normoinsulinemic-normal OGTT and pre-IGT groups.@*Methods@#Conducted at University of Santo Tomas Hospital, this was a retrospective analytical study of high-risk individuals for evaluation of type 2 diabetes from 2000-2011 and underwent 75-gm OGTT with 2-hour blood sugar and insulin determinations. The 2-hour glucose, insulin level and HbA1c in normoinsulinemic-normal OGTT were compared with the preIGT group using t-test. Correlation between the 2-hour blood glucose and insulin level with the HbA1c was done using Pearson correlation analysis. Statistical signifi cance was considered for p-value of <0.05@*Results@#Second-hour blood glucose and insulin levels were signifi cantly higher in the pre-IGT group as compared to the normoinsulinemic-normal OGTT group (128.60±18 and 89.29±68.82 vs. 90.68±26 and 17.40±8.15). The HbA1c of the pre-IGT group was signifi cantly higher than the normoinsulinemic-normal OGTT group (6.09±0.55 vs. 5.15±0.25, p-value <0.001). There was weak positive correlation between the HbA1c and 2-hour blood glucose levels between the two groups but not with the insulin levels.@*Conclusion@#The pre-IGT groups have signifi cantly higher 2nd hour blood sugar, insulin and HbA1c levels. This suggests that indeed the metabolic abnormality must be addressed as early as the pre-IGT stage.