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Titolo:
INDICATION AND RESULTS OF INSULIN THERAPY FOR GESTATIONAL DIABETES-MELLITUS
Autore:
HOPP H; VOLLERT W; RAGOSCH V; NOVAK A; WEITZEL HK; GLOCKNER E; BESCH W;
Indirizzi:
FREE UNIV BERLIN,KLINIKUM BENJAMIN FRANKLIN,DEPT OBSTET & GYNECOL,HINDENBURGDAMM 30 D-12200 BERLIN GERMANY CENT INST RES DIABET KARLSBURG GERMANY
Titolo Testata:
Journal of perinatal medicine
fascicolo: 5, volume: 24, anno: 1996,
pagine: 521 - 530
SICI:
0300-5577(1996)24:5<521:IAROIT>2.0.ZU;2-7
Fonte:
ISI
Lingua:
ENG
Soggetto:
SCREEN;
Keywords:
AMNIOTIC FLUID INSULIN; GESTATIONAL DIABETES; INSULIN TREATMENT;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
23
Recensione:
Indirizzi per estratti:
Citazione:
H. Hopp et al., "INDICATION AND RESULTS OF INSULIN THERAPY FOR GESTATIONAL DIABETES-MELLITUS", Journal of perinatal medicine, 24(5), 1996, pp. 521-530

Abstract

The aim of this study was to determine whether amniotic fluid insulinconcentration (AFI) is a better parameter than mean maternal blood glucose values (MBG) for deciding about insulin therapy in patients withgestational diabetes. MBG's were calculated on the base of 9 blood glucose levels during a 24 hour period after one week of diet therapy. In a prospective trial between 1987 and 1989 in Karlsburg, 123 gestational diabetic patients were randomized into two groups. Treatment was either based on the concentration of AFI or MBG levels. In a second series in Berlin, 103 patients were offered amniocentesis. 81 patients agreed and 22 refused. Treatment was then analogous to that in Karlsburg. In both groups of the randomized population, strict metabolic control was achieved. There was no difference regarding pregnancy complications. Earlier labor induction and higher cesarean section rates were seen in the non-invasive group (p < 0.05). The incidence of dia betic fetopathy and neonatal hypoglycemia was significantly lower in the invasive group (p < 0.01), even though the metabolic control parameters didnot differ between the two groups. The results in Berlin correspond to these findings. In conclusion, AFI enables the recognition of any hyperinsulinism reaction to the maternal metabolic situation. We recommend the additional measurement of the AFI concentration between 28 and 36 weeks as the direct fetal parameter for deciding about insulin treatment.

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Documento generato il 02/10/20 alle ore 01:33:02