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Related Concept Videos

Insulin: Dosing Regimen and Adverse Effects01:16

Insulin: Dosing Regimen and Adverse Effects

140
Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
140
Insulin Formulations: Types and Delivery01:27

Insulin Formulations: Types and Delivery

162
Insulin preparations are categorized by their duration of action into short-acting and long-acting types. Two strategies are used to modify insulin's absorption and pharmacokinetic profile: slowing the absorption post-subcutaneous injection, or altering human insulin's amino acid sequence or protein structure. These changes retain the insulin's ability to bind to the insulin receptor, but alter its behavior in solution or after injection.
Short-acting insulins are divided into...
162

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Related Experiment Video

Updated: May 28, 2025

Improving IV Insulin Administration in a Community Hospital
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Intrapartum Glycemic Control with Insulin Infusion versus Rotating Fluids: A Randomized Controlled Trial.

Maranda Sullivan1, Kajal Angras1, Victoria Boyd1

  • 1Department of Maternal-Fetal Medicine, Geisinger Medical Center, Danville, Pennsylvania.

American Journal of Perinatology
|February 10, 2025
PubMed
Summary
This summary is machine-generated.

Rotating IV fluids and insulin infusions show comparable results for maternal intrapartum glycemic control, with no significant difference in neonatal blood glucose levels within two hours of birth.

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Area of Science:

  • Obstetrics and Gynecology
  • Neonatal Medicine
  • Endocrinology

Background:

  • Effective intrapartum glycemic control is crucial for managing pregnant individuals with diabetes (type II DM or A2GDM).
  • Current management strategies aim to maintain stable maternal blood glucose to optimize neonatal outcomes.
  • Evaluating alternative methods for glycemic control during labor is essential.

Purpose of the Study:

  • To compare the efficacy of rotating intravenous (IV) fluids versus continuous insulin infusion for maternal intrapartum glycemic control.
  • To assess the impact of these interventions on neonatal blood glucose levels within 2 hours of birth.

Main Methods:

  • A randomized controlled trial involving 114 participants with type II DM or A2GDM.
  • Comparison of rotating IV fluids against continuous insulin infusion for intrapartum glycemic management.
  • Analysis of neonatal blood glucose at 2 and 24 hours, Apgar scores, and composite neonatal outcomes; maternal outcomes included hypoglycemia and delivery mode.

Main Results:

  • No significant difference in neonatal blood glucose levels within 2 hours of birth between the rotating IV fluids group (54.5 mg/dL ITT) and the insulin infusion group (59.0 mg/dL ITT).
  • Comparable maternal intrapartum blood glucose levels (98.5 mg/dL vs. 96.3 mg/dL) and similar rates of neonatal hypoglycemia (11.8% vs. 15.6%) were observed.
  • No significant differences were found in secondary neonatal or maternal outcomes between the two treatment arms.

Conclusions:

  • Rotating IV fluids are as effective as continuous insulin infusion for intrapartum glycemic control in pregnant individuals with diabetes.
  • Both methods result in comparable neonatal blood glucose levels and do not significantly alter key neonatal or maternal outcomes.
  • There is currently no definitively optimal option for maternal glycemic control during labor based on this comparison.