Steel J M, Johnstone F D, Hume R, Mao J H
Department of Diabetes, Royal Infirmary of Edinburgh, Scotland.
Obstet Gynecol. 1994 Feb;83(2):253-8.
To document individual variations in the rise in insulin requirements during type I diabetic pregnancies, to relate the degree of increase to maternal characteristics and fetal outcome, and to examine these factors in a subgroup of patients experiencing a large fall in insulin requirement in the third trimester.
Insulin dose was documented in 237 pregnancies in women with type I diabetes. Multiple regression analysis was performed to identify significant associations with maternal and fetal characteristics. Eighteen pregnancies with a fall in insulin requirement of 30% or more in the third trimester were considered in detail.
The mean absolute increase in insulin requirement was 52 units. The degree of rise was significantly related to maternal weight gain between 20-29 weeks and maternal weight at booking, and was inversely related to duration of diabetes. It was not related to the degree of diabetes control, complications of pregnancy, White class, or outcome of pregnancy. In the 18 women experiencing a large fall in insulin requirement, there was no relation with maternal characteristics or fetal outcome.
There is a wide individual variation in the change in insulin requirements in type I diabetic pregnancy. The degree of increase is related only to maternal weight gain during weeks 20-29 and maternal weight at booking, and is inversely related to duration of diabetes. Large falls in insulin requirement remain unexplained and may not be associated with placental failure.
记录I型糖尿病孕妇胰岛素需求量增加的个体差异，将增加程度与母亲特征及胎儿结局相关联，并在孕晚期胰岛素需求量大幅下降的患者亚组中研究这些因素。
记录了237例I型糖尿病女性的妊娠期间胰岛素剂量。进行多元回归分析以确定与母亲和胎儿特征的显著关联。详细研究了18例孕晚期胰岛素需求量下降30%或更多的妊娠。
胰岛素需求量的平均绝对增加量为52单位。增加程度与20 - 29周期间母亲体重增加及孕早期母亲体重显著相关，与糖尿病病程呈负相关。它与糖尿病控制程度、妊娠并发症、怀特分类或妊娠结局无关。在18例胰岛素需求量大幅下降的女性中，与母亲特征或胎儿结局无关。
I型糖尿病妊娠期间胰岛素需求量的变化存在广泛的个体差异。增加程度仅与20 - 29周期间母亲体重增加及孕早期母亲体重相关，与糖尿病病程呈负相关。胰岛素需求量的大幅下降仍无法解释，且可能与胎盘功能不全无关。
