Center for Pregnant Women with Diabetes, Rigshospitalet, Blegdamsvej 9, Copenhagen, DK-2100, Denmark.
Department of Nephrology and Endocrinology, Rigshospitalet, Blegdamsvej 9, Copenhagen, DK-2100, Denmark.
Curr Diab Rep. 2024 Nov 22;25(1):7. doi: 10.1007/s11892-024-01563-1.
To provide an update on diabetes management during labour and delivery in women with type 1 diabetes with focus on appropriate insulin administration, carbohydrate supply and use of diabetes technology to support safe delivery and neonatal well-being.
During active labour and elective cesarean section capillary blood glucose monitoring or continuous glucose monitoring at least hourly is recommended. Infusion with isotonic (5%) glucose can be given with adjustable infusion rate to address maternal carbohydrate requirements and to prevent maternal hypoglycemia. Subcutaneous insulin administration with multiple injections or insulin pump therapy is considered at least as safe and efficient as intravenous administration to obtain tight glycemic targets. Automated insulin delivery via insulin pump can be continued during labour and delivery. Diabetes management during labour and delivery involves intensive glucose monitoring, adequate insulin administration and carbohydrate administration to support safe delivery and neonatal well-being.
重点介绍 1 型糖尿病女性分娩期间的糖尿病管理，包括适当的胰岛素给药、碳水化合物供应以及使用糖尿病技术以支持安全分娩和新生儿健康。
在活跃分娩和选择性剖宫产期间，建议至少每小时监测毛细血管血糖或连续血糖监测。可给予等渗（5%）葡萄糖输注，并可调节输注率以满足产妇的碳水化合物需求并预防产妇低血糖。与静脉内给药相比，多次注射或胰岛素泵治疗的皮下胰岛素给药至少同样安全且有效，以达到严格的血糖目标。通过胰岛素泵的自动胰岛素输送可在分娩和分娩期间继续进行。分娩期间的糖尿病管理包括强化血糖监测、充分的胰岛素给药和碳水化合物给药，以支持安全分娩和新生儿健康。
