Sukarna, Nuraini and Tan, Peng Chiong and Hong, Jesrine Gek Shan and Sulaiman, Sofiah and Omar, Siti Zawiah (2021) Glycemic control following two regimens of antenatal corticosteroids in mild gestational diabetes: A randomized controlled trial. Archives of Gynecology and Obstetrics, 304 (2). pp. 345-353. ISSN 0932-0067, DOI https://doi.org/10.1007/s00404-020-05950-3.
Full text not available from this repository.Abstract
Purpose To compare 3 consecutive days of hyperglycemic response following antenatal dexamethasone regimens of 12-mg or 6-mg doses 12 hourly in diet-controlled gestational diabetes. Methods A randomized controlled trial was carried out in a university hospital in Malaysia. Women with lifestyle-controlled gestational diabetes scheduled to receive clinically indicated antenatal corticosteroids (dexamethasone) were randomized to 12-mg 12 hourly for one day (2 x 12-mg) or 6-mg 12-hourly for two days (4 x 6-mg). 6-point (pre and 2-h postprandial) daily self-monitoring of capillary blood sugar profile for up to 3 consecutive days was started after the first dexamethasone injection. Hyperglycemia is defined as blood glucose pre-meal >= 5.3 or 2 h postprandial >= 6.7 mmol/L. The primary outcome was a number of hyperglycemic episodes in Day-1 (first 6 BSP points). A sample size of 30 per group (N = 60) was planned. Results Median interquartile range] hyperglycemic episodes 4 2.5-5] vs. 4 3-5] p = 0.3 in the first day, 3 2-4] vs. 1 0-3] p = 0.01 on the second day, 0 0-1] vs. 0 0-1] p = 0.6 on the third day and over the entire 3 trial days 7 6-9] vs. 6 4-8] p = 0.17 for 6-mg vs. 12-mg arms, respectively. 2/30 (7%) in each arm received an anti-glycemic agent during the 3-day trial period (capillary glucose exceeded 11 mmol/L). Mean birth weight (2.89 vs. 2.49 kg p < 0.01) and gestational age at delivery (37.7 vs. 36.6 weeks p = 0.03) were higher and median delivery blood loss (300 vs. 400 ml p = 0.02) was lower in the 12-mg arm; all other secondary outcomes were not significantly different. Conclusion In gestational diabetes, 2 x 12-mg could be preferred over 4 x 6-mg dexamethasone as hyperglycemic episodes were fewer on Day-2, fewer injections were needed and the regimen was completed sooner.
| Item Type: | Article |
|---|---|
| Funders: | Department of Obstetrics and Gynecology, University Malaya |
| Uncontrolled Keywords: | Antenatal corticosteroids; Dexamethasone; Gestational diabetes mellitus; Blood sugar profile; Self-monitoring of blood glucose |
| Subjects: | R Medicine > RG Gynecology and obstetrics |
| Divisions: | Faculty of Medicine |
| Depositing User: | Ms Zaharah Ramly |
| Date Deposited: | 20 Jun 2022 01:08 |
| Last Modified: | 20 Jun 2022 01:08 |
| URI: | http://eprints.um.edu.my/id/eprint/27947 |
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