Effect Of Glucocorticoid On Blood Glucose And Insulin In Gestational Patients With Diabetes Mellitus During Late Pregnancy

Objective To evaluate the effects of glucocorticoids on blood glucose and insulin levels in gestational patients with diabetes during late pregnancy,and to explore the time and range of blood glucose fluctuation in gestational patients with diabetes after using glucocorticoids to promote fetal lung maturation,so as to provide research data for clinical work.Methods Choose between December 2020 and December 2021 in Inner Mongolia medical university affiliated hospital treated with corticosteroids to promote fetal lung maturity with the risk of a pre-term birth 28 to 34 weeks of gestation,a total of 90 cases of pregnant women,the experimental group was divided into gestational diabetes(group gestational diabetes mellitus,GDM)group,diabetic pregnancies(pregestational diabetes mellitus,PGDM)group,control group for obstetric complications group,30 cases.Blood glucose and insulin levels were monitored and detected before and after glucocorticoid administration,and pregnancy outcomes were followed up.Results 1.General data There were no significant differences in age,gestational age,delivery situation and BMI between GDM and PGDM in experimental group and control group(P>0.05).2.Fasting glucose levels of GDM,PGDM and control group before and after glucocorticoid treatment were significantly higher than those of control group at24 h and 48 h time points(P<0.05),and fasting glucose levels of GDM,PGDM and control group were increased after treatment,and decreased to the level before treatment at 72 h time point.Postprandial blood glucose levels in experimental group GDM,PGDM and control group after glucocorticoid treatment,postprandial blood glucose levels in PGDM group were significantly lower than those in GDM group and control group,statistically significant differences were found(P<0.05),fasting blood glucose and postprandial blood glucose levels in all three groups increased after medication.3.Insulin levels of GDM,PGDM and control group before and after glucocorticoid treatment were significantly higher than those of control group at24 h and 48 h time points,and insulin levels of PGDM group were the most significant(P<0.05).Insulin levels of GDM,PGDM and control group increased after treatment.At the 72 h time point,it was reduced to pre-medication levels.4.There was no significant difference in pregnancy outcome between GDM,PGDM and control group after glucocorticoid treatment(P>0.05).The rate of neonatal hypoglycemia was higher in PGDM group,and the rate of neonatal asphyxia was higher in GDM group,and the difference was significant(P<0.05).Conclusion 1.The use of glucocorticoids in gestational patients with diabetes mellitus in the third trimester can increase blood glucose and insulin levels.The glucose and insulin levels of GDM and PGDM patients increased most significantly after medication,especially within 48 hours after medication,and reached the peak at 24 hours after medication.Among them,fasting and postprandial blood glucose levels of GDM patients increased most significantly,while insulin levels of PGDM patients were most significantly affected by glucocorticoid.PGDM patients maintained high insulin levels 24-48 hours after medication.These fluctuations in blood glucose and insulin levels continue for at least 72 hours to return to pre-medication levels.2.This study has not been found in patients with gestational diabetes mellitus late pregnancy using glucocorticoids clear adverse impact on maternal and infant outcomes,suggestion of the risk of a pre-term birth gestational diabetes mellitus patients with careful use of glucocorticoid hormone drugs to promote fetal lung maturation treatment,medication is closely monitoring the blood sugar level,timely adjustment of nutrition,exercise,or drug treatment,Thus reduce the occurrence of adverse pregnancy outcomes.