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Decreasing Insulin Requirements in Pregnancy With Pre-existing or Gestational Diabetes: Management Practices Across
Allison Pihelgas1, Alexandra Prior1, Maria B Ospina1
1Department of Obstetrics & Gynecology, University of Alberta, Edmonton, AB.
Decreasing insulin requirements in pregnant women with preexisting or gestational diabetes has been attributed to placental insufficiency, which results in increased surveillance or early delivery. This practice is not evidence based. A 5-item questionnaire was administered electronically to a convenience sample of Canadian resident and staff obstetrician-gynaecologists and maternal-fetal medicine specialists. Practice patterns varied widely among the 142 survey respondents, and this variation did not correlate to their level of training. There is a paucity of evidence to guide the management of patients with decreasing insulin requirements, which is reflected in varied and possibly unnecessary clinical interventions.
Decreasing insulin requirements in pregnant women with preexisting or gestational diabetes has been attributed to placental insufficiency, which results in increased surveillance or early delivery. This practice is not evidence based. A 5-item questionnaire was administered electronically to a convenience sample of Canadian resident and staff obstetrician-gynaecologists and maternal-fetal medicine specialists. Practice patterns varied widely among the 142 survey respondents, and this variation did not correlate to their level of training. There is a paucity of evidence to guide the management of patients with decreasing insulin requirements, which is reflected in varied and possibly unnecessary clinical interventions.
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