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Maternal glucose intolerance and the subcutaneous terbutaline pump
C Lindenbaum1, J Ludmir, F B Teplick
1Department of Obstetrics and Gynecology, University of Pennsylvania Medical Center, Philadelphia 19104.
Objective:
Our hypothesis was that use of the subcutaneous terbutaline pump does not affect maternal glucose tolerance.
Study Design:
With the 1-hour glucose tolerance test, we examined the incidence of glucose intolerance in 37 patients using the pump compared with that of 54 patients receiving oral terbutaline and 634 control subjects without risk factors for gestational diabetes. The frequency of gestational diabetes and the need for insulin to maintain glycemic control were subjected to chi 2 analysis.
Results:
The incidence of gestational diabetes was 6% in the control subjects, 5% in patients using the pump (p = 0.8), and 11% in those on the oral therapy regimen (p = 0.4). A total of 8% of controls who had gestational diabetes required both insulin and diet, compared with 100% using the pump (p less than 0.01) and 50% on the oral terbutaline regimen (p = 0.03).
Conclusion:
The incidence of gestational diabetes is not increased in patients receiving terbutaline via the subcutaneous pump. The use of terbutaline by any route significantly increases the need for insulin to achieve glycemic control.