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Korean Journal of Obstetrics & Gynecology 2001;44(4):812-817.
Published online April 1, 2001.
Three Cases Reports of Hyperglycemic Control with 4 Times Daily Administration of Insulin on Diabetes in Pregnancy.
D H Lim, J M Yoon, S E Lee, J P Kim, K M Song, S W Hwang, S K Ko, S Cho, W Y Lee
Department of Obstetrics and Gynecology, College of medicine, Inha University, Inha Hospital, Korea.
Insulin therapy is indicated in the treatment of gestational diabetic women and pregnant overt diabetic women for hyperglycemia after failure to respond to the diet and exercise regimen. If both the fasting and postprandial glucose levels are elevated or if a women's postprandial glucose levels can only be blunted if starvation ketosis occurs, a four-injection-per-day regimen of insulin is prescribed. The insulin is administered to mimic normal pancreatic function. The normal pancreas secretes 50 % of the insulin as mealtime boluses. This delivery may be mimicked by four-injection-per-day of combination of NPH and regular insulin. 6 or more glucose measurements each day may be required to optimize therapeutic effect and ensure a smooth increase of insulin as the pregnancy progresses to a higher insulin requirement. Here we report 3 cases of hyperglycemic control with four times daily administration of insulin on diabetes in pregnancy, with brief reviews.
Key Words: Diabetes mellitus, Insulin, A four-injection-per-day, Glycemic control

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