NORMALIZATION OF BLOOD GLUCOSE LEVEL AND MARKED DECREASE IN INSULIN ANTIBODIES BY CONTINUOUS SUBCUTANEOUS INSULIN INFUSION (CSII) IN UNSTABLE DIABETIC DURING PREGNANCY

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  • HIRANO Tsutomu
    The 1st Department of Internal Medicine, School of Medicide, Showa University
  • CHIN Somei
    The 1st Department of Internal Medicine, School of Medicide, Showa University
  • INABA Masahisa
    The 1st Department of Internal Medicine, School of Medicide, Showa University
  • TAKESHITA Hikaru
    The 1st Department of Internal Medicine, School of Medicide, Showa University
  • TSUJI Masatomi
    The 1st Department of Internal Medicine, School of Medicide, Showa University
  • NAGANO Seishi
    The 1st Department of Internal Medicine, School of Medicide, Showa University

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Other Title
  • インスリン持続皮下注入法 (CSII) により長期血糖の正常化とインスリン抗体の減少を可能とした糖尿病妊婦の一例
  • インスリン持続皮下注入法(CS2)により長期血糖の正常化とインスリン抗体の減少を可能とした糖尿病妊婦の1例
  • インスリン ジゾク ヒカ チュウニュウホウ CS 2 ニ ヨリ チョウキ ケッ

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In this report, we examine the case of a 26-year-old unstable diabetic woman who had lost a baby 2 years previously by intrauterine fetal death in the 32 th gestational week. Her diabetic control by conventional insulin treatment was aggravated during the second pregnancy, we attempted to treat her by Continuous Subcutaneous Insulin Infusion (CSII) with a portable pump. Although the total daily insulin dose required was 44% less than the conventional dose used before CSII, a marked improvement in blood glucose control was achieved (MBG, M-value, MAGE all were improved) and glycosylated hemoglobin level was normalized. Furthermore, the high level of insulin antibodies in the conventional treatment rapidly fell after CSII (NSB 32% VS 11%) . The proportion of the total daily insulin dose delivered as basal insulin remained unchanged throughout the pregnancy (50-55%) . After her discharge, she experienced no hypoglycemic attacks, and the course of her pregnancy was normal. We conclude that CSII is a highly efficient way to achieve normal blood glucose levels in a brittle diabetic during pregnancy, and also effective in reducing insulin antibodies.

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