Atkin S L, Lindow S W, Walton C, Masson E A
Department of Medicine, Hull Royal Infinnary, UK.
Diabet Med. 1996 Jun;13(6):589-91. doi: 10.1002/(SICI)1096-9136(199606)13:6<589::AID-DIA106>3.0.CO;2-P.
A 35-year-old insulin-dependent diabetic woman presented at 8 weeks gestation with multiple severe hypoglycaemic episodes occurring during the day and night without warning. Her pre-pregnancy insulin dosage of 45 units daily was progressively reduced by 73% to 12 units daily by week 17 because of multiple hypoglycaemic episodes. Investigation showed no pathological cause for the hypoglycaemia. Insulin dosage increased to 16 units daily by week 19 and then increased sharply to 60 units daily at 23 weeks and finally to 72 units at week 37. Following delivery her insulin dosage returned to pre-pregnancy values. Insulin-dependent diabetic women may rarely develop exaggerated insulin sensitivity in the first trimester of pregnancy resulting in severe hypoglycaemia, but spontaneous improvement occurs with increasing insulin resistance in the second and third trimesters.
一名35岁的胰岛素依赖型糖尿病女性在妊娠8周时就诊，白天和夜间均出现多次无预警的严重低血糖发作。由于多次低血糖发作，她孕前每日45单位的胰岛素剂量在孕17周时逐渐减少了73%，降至每日12单位。检查未发现低血糖的病理原因。胰岛素剂量在孕19周时增至每日16单位，然后在孕23周时急剧增至每日60单位，最终在孕37周时增至72单位。分娩后，她的胰岛素剂量恢复到孕前水平。胰岛素依赖型糖尿病女性在妊娠早期可能很少会出现胰岛素敏感性过度增强，从而导致严重低血糖，但在妊娠中晚期随着胰岛素抵抗增加，低血糖会自发改善。
