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Re: 35w diabetic needing less insulinFrom: Lynn D. Montgomery (apgar10@ionet.net)Mon Mar 25 09:39:16 1996
>On Sun, 24 Mar 1996 16:34:11 -0600 (CST), you wrote: > >>Tomorrow we are delivering (by C/S) a 35w diabetic mainly on the grounds that >>her insulin requirements have halved over the last 2 weeks. > >Wow. Has there been any non-reassuring fetal testing? What data are >you using to support the decision to section for decreasing insulin >requirements? > >Conventional wisdom dictates that falling insulin requirements dictate decreased placental function (i.e. decreased placental lactogen-less insulin resistance). Prior to the availability of fetal testing, this was an indication for delivery. At present, with a variety of testing modalities from NST through doppler, it would be safer to follow this infant closely until lung maturity is obtained, then deliver.
> Lynn Montgomery, M.D. Maternal-Fetal Medicine Tulsa, Oklahoma
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