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Re: 35w diabetic needing less insulinFrom: Roland Armstrong (rjarm@northernnet.com)Wed Mar 27 22:49:53 1996
>I'd agree with most of this but not about the worthlessness of steroids. >To say you'd do amniocentesis for lung maturity and then say no to >steroids seems to be contradictory. Steroids improve lung maturity. If >you think lungs mightn't be mature surely there is some merit. All the >reviews say steroids decrease by half the incidence of RDS *at any >gestation*. Sure for most women steroids at 35 weeks are not of great >value because RDS risk is low. However it is increased by pre-labour CS >and diabetes. There is even a multicentre trial running of steroids >prior to elective term CS ( = ASTECS ). > >Yes steroids do Sometimes increase blood glucose, but its chronic >hyperglycaeima that's the problem not 24 hours worth. >-- >Malcolm Griffiths MD,MRCOG,MFFP,Cert.Mgmnt > I agree, again with most of what you say. I would give steroids if amnio indicated immaturity, but not emperically as I stated in my previous reply. Maybe someday this will be indicated, but not now. I have seen dramatic increases in blood glucose within 24 hours in diabetics with steroids. Don't think it's only long term. RAJA.
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