Kakoulidis Ioannis, Ilias Ioannis, Linardi Anastasia, Michou Aikaterini, Milionis Charalampos, Petychaki Foteini, Venaki Evangelia, Koukkou Eftychia
Department of Endocrinology, Diabetes and Metabolism, Elena Venizelou General and Maternity Hospital, GR-11521 Athens, Greece.
Healthcare (Basel). 2020 Feb 17;8(1):40. doi: 10.3390/healthcare8010040.
Betamethasone (BM) administration in pregnancy has been shown to reduce the incidence and severity of neonatal respiratory distress syndrome. Its known diabetogenic impact, combined with placental insulin resistance, leads to a transient increase in glycemia. However, its effect on glucose homeostasis in pregnancy has not been adequately investigated. We closely monitored and assessed the glycemic profile of 83 pregnant women, with normal glucose metabolism, who were given BM during their hospitalization due to threatened premature labor. A significant change in the glycemic profile in most patients was noted, lasting 1.34 ± 1.05 days. Sixty-six of eighty-three women were eventually treated with insulin to maintain glycemia within acceptable limits. The mean ± SD insulin dosage was 12.25 ± 11.28 units/day. The need for insulin therapy was associated with higher BM doses and the presence of marginal values in the 75-g oral glucose tolerance test (OGTT) at 60 min. Our study demonstrates, following BM administration, the need for increased awareness and individualized monitoring/treatment of pregnant women with normal-yet marginal-values in the 75-g OGTT.
孕期使用倍他米松（BM）已被证明可降低新生儿呼吸窘迫综合征的发病率和严重程度。其已知的致糖尿病作用，加上胎盘胰岛素抵抗，会导致血糖短暂升高。然而，其对孕期葡萄糖稳态的影响尚未得到充分研究。我们密切监测并评估了83名葡萄糖代谢正常的孕妇的血糖情况，这些孕妇因先兆早产住院期间接受了BM治疗。大多数患者的血糖情况有显著变化，持续时间为1.34±1.05天。83名女性中有66名最终接受胰岛素治疗以将血糖维持在可接受范围内。胰岛素平均剂量±标准差为12.25±11.28单位/天。胰岛素治疗的需求与更高的BM剂量以及75克口服葡萄糖耐量试验（OGTT）60分钟时的临界值有关。我们的研究表明，在使用BM后，对于75克OGTT结果正常但处于临界值的孕妇，需要提高认识并进行个体化监测/治疗。
