Weiss P A, Winter R
Geburtshilfe Frauenheilkd. 1982 Feb;42(2):91-3. doi: 10.1055/s-2008-1036643.
In 25 insulin-dependent female diabetics of the B to D categories according to White, the daily insulin requirement was determined between the 8th and 40th week of pregnancy. The purpose of this study was to keep the mean blood sugar below 100 mg% by means of administration of old insulin. From the 28th week the metabolic balance was additionally modified by means of the insulin content of the amniotic fluid. In all cases spontaneous initiation of delivery was awaited. All women gave birth to healthy babies of normal weight without any sign of diabetogenic foetopathy. The insulin requirement of the whole group rose from an average of 32 units in the 8th week to 66 units in the 36th week of pregnancy and decreased subsequently. The requirement increases at first as represented by a flat curve which acquires a distinctly greater slope between the 28th and 36th weeks. In White B, C, and D diabetics the initial requirement is on the average 23, 35 and 45 units per 24 hours. the maximum requirement being on the average 2.4, 2.0 or 1.7 times the initial figure. The drop in insulin requirement after the 36th week is physiological and does not point to any hazard as far as the foetus is concerned.
在25名根据怀特分类法属于B至D类的胰岛素依赖型女性糖尿病患者中，在妊娠第8周至第40周期间确定了每日胰岛素需求量。本研究的目的是通过给予旧胰岛素使平均血糖保持在100mg%以下。从第28周起，通过羊水的胰岛素含量对代谢平衡进行额外调整。在所有情况下，均等待自然发动分娩。所有女性均产下体重正常的健康婴儿，无任何致糖尿病胎儿病变的迹象。整个组的胰岛素需求量从妊娠第8周的平均32单位增至第36周的66单位，随后下降。需求量起初增加，呈平缓曲线，在第28周至第36周之间斜率明显增大。在怀特B、C和D类糖尿病患者中，初始需求量平均每24小时分别为23、35和45单位。最大需求量平均为初始数值的2.4、2.0或1.7倍。第36周后胰岛素需求量的下降是生理性的，就胎儿而言并不表明有任何危险。
