Technical advance

Use of real time continuous glucose monitoring and intravenous insulin in type 1 diabetic mothers to prevent respiratory distress and hypoglycaemia in infants

Dario Iafusco¹ , Fabrizio Stoppoloni^2* , Gennaro Salvia^3* , Gilberto Vernetti^2* , Patrizia Passaro^1* , Goran Petrovski^4* and Francesco Prisco^1*

¹  Department of Paediatrics, Second University of Naples, Italy

²  Maternal-Fetal Medicine Unit, Buon Consiglio Fatebenefratelli Hospital, Naples, Italy

³  Neonatology and N.I.C.U. , Buon Consiglio Fatebenefratelli Hospital, Naples, Italy

⁴  Clinic of Endocrinology and Diabetes, Skopje, Former Yugoslav Republic of Macedonia

author email corresponding author email* Contributed equally

BMC Pregnancy and Childbirth 2008, 8:23doi:10.1186/1471-2393-8-23

Published:	1 July 2008

Abstract

Background

Pregnancy in Type 1 diabetic patients is a precarious condition, both for mother and fetus with increased the risk of prematurity and, immediately after delivery with risk of respiratory distress syndrome and hypoglycaemia in newborns. A strict control and monitoring of diabetes throughout pregnancy is important in reducing the impact of the disease on the fetus and newborn. In recent years many new technologies have been introduced to ameliorate diabetes monitoring, where the last is the Real-time Continuous Glucose Monitoring System (RT-CGMS).

Methods

In the last three years, 72 h continuous glucose monitoring system (RT-CGMS) (Medtronic, CA) was performed in 18 pregnant women with Type 1 diabetes in two moments of pregnancy: during treatment with betamethasone to prevent respiratory distress and during delivery. In both cases insulin was administered intravenous and the dose was changed on the basis of glycaemia.

Results

The results present the use of this new technique during two topics moments of pregnancy of type 1 diabetes patients when is very important intensively to monitor diabetes and to obtain the well being of the fetus. No infant experimented hypoglycaemia or respiratory distress syndrome at the moment and in the first hours after the birth.

Conclusion

We wish to stress the importance reducing glycaemia during administration of betamethasone and during labor. It is conceivable that the scarce attention paid to monitoring glucose levels in diabetic mothers during labor in gynaecological world may be due to the difficulty in glucose monitoring with the devices until now available. Hopefully, our anecdotal account may prompt improvements with RT-CGMS, and may lead to a better approach to the problem, thereby changing the prognosis of infants born to diabetic mothers.