Comparison of Hyperglycemic Effects of Antenatal Administration of Dexamethasone in Gestational Diabetes: A Study of Recommended Versus Predicted Split Doses Regimens

Authors

  • Shagufta Parveen Department of Obstetrics and Gynecology, Combined Military Hospital, Kharian Medical College Khaian/National University of Medical Sciences (NUMS) Pakistan
  • Saima Batool Department of Pediatrics, University College of Medicine & Dentistry, Lahore Pakistan
  • Saima Rafique Department of Obstetrics and Gynecology, University College of Medicine & Dentistry, Lahore Pakistan
  • Nabila Iram Department of Obstetrics and Gynecology, Prince Alexandra Hospital, Harlow England
  • Rabeya Rehman Department of Pediatrics, Sargodha Medical College, Sargodah Pakistan
  • Iffat Rafeeq Department of General Medicine, Combined Military Hospital, Kharian Medical College Kharian/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i2.8955

Keywords:

Dexamethasone, Gestational Diabetes Mellitus, Preterm Labour, Respiratory distress

Abstract

Objective: To compare three consecutive days of hyperglycemic response following antenatal Dexamethasone regimens of 12mg or 6mg in diet-controlled gestational diabetes, administered for fetal lung maturity.

Study Design: Quasi-experimental study

Place and Duration of Study: Department of Obstetrics and Gynaecology, Combined Military Hospital, Kharian Pakistan, from Oct 2020 to Mar 2021.

Methodology: Forty women who met inclusion criteria were selected and assigned to two Groups. Group-A was administered quartered 24 mg steroids 6 hours daily, and Group-B was administered halved 24mg 12 hours daily. Blood sugar levels (BSL) were recorded before and after meals, thrice a day for three consecutive days, and on proforma.

Results: Among the selected patients, the mean age was 25.5±2.9 years, and the mean gestational age (duration of pregnancy) was 30.3±2.0 weeks. Out of six blood sugar levels recorded daily for three consecutive days, the episodes of hyperglycemia in the (Group-B) 12-hourly steroid dose were found to be less significant than those in the (Group-A) split 6-hourly dose.

Conclusion: The recommended 12 mg, twice-a-day regimen of antenatal corticosteroids was better than the proposed 6mg, four times a day regimen as it caused fewer hyperglycemic episodes in gestational diabetics.

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References

Jehan I, Harris H, Salat S, Zeb A, Mobeen N, Pasha O, et al.

Neonatal mortality, risk factors and causes: a prospective

population-based cohort study in urban Pakistan. Bull World

Health Organ 2009; 87(2): 130-138.

https://doi.org/10.2471/blt.08.050963

International Association of Diabetes and Pregnancy Study

Groups Consensus Panel; Metzger BE, Gabbe SG, Persson B,

Buchanan TA, Catalano PA, Damm P, et al. International

association of diabetes and pregnancy study groups

recommendations on the diagnosis and classification of

hyperglycemia in pregnancy. Diabetes Care 2010; 33(3): 676-682.

https://doi.org/10.2337/dc09-1848

Takeda A, Martin N, Taylor RS, Taylor SJ. Disease management

interventions for heart failure. Cochrane Database Syst Rev 2019;

(1): CD002752.

https://doi.org/10.1002/14651858.CD002752.pub4

Committee on Obstetric Practice. Committee Opinion No. 713:

Antenatal Corticosteroid Therapy for Fetal Maturation. Obstet

Gynecol 2017; 130(2): e102-e109.

https://doi.org/10.1097/AOG.0000000000002237

Persson B, Hanson U. Neonatal morbidities in gestational

diabetes mellitus. Diabetes Care 1998; 21 Suppl 2: B79-84.

Battarbee AN, Venkatesh KK, Aliaga S, Boggess KA. The

association of pregestational and gestational diabetes with

severe neonatal morbidity and mortality. J Perinatol 2020; 40(2):

-239. https://doi.org/10.1038/s41372-019-0516-5

Wapner R, Jobe AH. Controversy: antenatal steroids. Clin

Perinatol 2011; 38(3): 529-545.

https://doi.org/10.1016/j.clp.2011.06.013

Moyce BL, Dolinsky VW. Maternal β-Cell Adaptations in

Pregnancy and Placental Signalling: Implications for Gestational

Diabetes. Int J Mol Sci 2018; 19(11): 3467.

https://doi.org/10.3390/ijms19113467

ACOG Committee Opinion No. 475: antenatal corticosteroid

therapy for fetal maturation. Obstet Gynecol 2011; 117(2 Pt 1):

-424. https://doi.org/10.1097/AOG.0b013e31820eee00

Mushkat Y, Ascher-Landsberg J, Keidar R, Carmon E, Pauzner

D, David MP. et al. The effect of betamethasone versus

dexamethasone on fetal biophysical parameters. Eur J Obstet

Gynecol Reprod Biol 2001; 97(1): 50-52.

https://doi.org/10.1016/s0301-2115(00)00498-x

Fatima SS, Rehman R, Alam F, Madhani S, Chaudhry B, Khan

TA. et al. Gestational diabetes mellitus and the predisposing

factors. J Pak Med Assoc 2017; 67(2): 261-265.

Dashora U, Murphy HR, Temple RC, Stanley KP, Castro E,

George S, et al; Joint British Diabetes Societies (JBDS) for

Inpatient Care. Managing hyperglycaemia during antenatal

steroid administration, labour and birth in pregnant women

with diabetes. Diabet Med 2018; 35(8): 1005-1010.

https://doi.org/10.1111/dme.13674

American Diabetes Association. 12. Management of Diabetes in

Pregnancy. Diabetes Care 2016; 39 Suppl 1: S94-98.

https://doi.org/10.2337/dc16-S015

Hu Kl, Zhao H, Yu Y, Li R. Kisspeptin as a potential biomarker

throughout pregnancy. Eur J Obstet Gynecol Reprod Biol 2019;

: 261–266. https://doi.org/10.1016/j.ejogrb.2019.07.016

Hill M, Pařízek A, Šimják P, Koucký M, Anderlová K, Krejčí H,

et al. Steroids, steroid associated substances and gestational

diabetes mellitus. Physiol Res 2021; 70(Suppl4): S617-S634.

https://doi.org/10.33549/physiolres.934794

Itoh A, Saisho Y, Miyakoshi K, Fukutake M, Kasuga Y, Ochiai D,

et al. Time-dependent changes in insulin requirement for

maternal glycemic control during antenatal corticosteroid

therapy in women with gestational diabetes: a retrospective

study. Endocr J 2016; 63(1): 101-104.

https://doi.org/10.1507/endocrj.EJ15-0482

Kalra S, Kalra B, Gupta Y. Glycemic management after antenatal

corticosteroid therapy. N Am J Med Sci 2014; 6(2): 71-76.

https://doi.org/10.4103/1947-2714.127744

Faal S, Abedi P, Jahanfar S, Ndeke JM, Mohaghegh Z,

Sharifipour F, et al. Sex hormone binding globulin for prediction

of gestational diabetes mellitus in pre-conception and

pregnancy: A systematic review. Diabetes Res Clin Pract 2019;

: 39-52. https://doi.org/10.1016/j.diabres.2019.04.028

Sukarna N, Tan PC, Hong JGS, Sulaiman S, Omar SZ. Glycemic

control following two regimens of antenatal corticosteroids in

mild gestational diabetes: a randomized controlled trial. Arch

Gynecol Obstet 2021; 304(2): 345-353.

https://doi.org/10.1007/s00404-020-05950-3

Bowe JE, Hill TG, Hunt KF, Smith LI, Simpson SJ, Amiel SA, et

al. A role for placental kisspeptin in β cell adaptation to

pregnancy. JCI Insight. 2019; 4(20): e124540.

https://doi.org/10.1172/jci.insight.124540

Feng Y, Feng Q, Qu H, Song X, Hu J, Xu X, et al. Stress

adaptation is associated with insulin resistance in women with

gestational diabetes mellitus. Nutr Diabetes 2020; 10(1): 4.

https://doi.org/10.1038/s41387-020-0107-8

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Published

29-04-2024

How to Cite

1.
Shagufta Parveen, Saima Batool, Saima Rafique, Nabila Iram, Rabeya Rehman, Iffat Rafeeq. Comparison of Hyperglycemic Effects of Antenatal Administration of Dexamethasone in Gestational Diabetes: A Study of Recommended Versus Predicted Split Doses Regimens. Pak Armed Forces Med J [Internet]. 2024 Apr. 29 [cited 2024 May 24];74(2):438-41. Available from: https://pafmj.org/PAFMJ/article/view/8955

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