Betamethasone
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Insulin resistance: case report A 23-year-old woman experienced marked insulin resistance and a deterioration in glycaemic control while receiving betamethasone during her third trimester of pregnancy. The woman, who had Class B diabetes mellitus, received two doses of IM betamethasone [dosage not stated] in week 35 of her pregnancy, in anticipation of a preterm delivery. She had been receiving insulin suspension isophane and insulin glulisine in her third trimester, and her blood glucose control had been at goal. After receiving betamethasone, her glycaemic control deteriorated [time to reaction not clearly stated]. The woman’s insulin was titrated and she received insulin for the remainder of her pregnancy, with excellent control. At 37 weeks, she had a spontaneous vaginal delivery. She did not require any insulin after her delivery and was discharged receiving glibenclamide. Author comment: "Studies in islets have shown that placental lactogens/somatogens and glucocorticoids have opposing effects on islet gene expression ... We postulate that in our patient the administration of two doses of betamethasone compromised the delicate balance between these opposing effects which reverted only after pregnancy." Dharashivkar SA, et al. Prolonged Deterioration of Glycemic Control and Marked Insulin Resistance after Only Two Doses of Betamethasone during Pregnancy. 94th Annual Meeting of the Endocrine Society : abstr. MON-185, 23 Jun 2012. Available from: URL: http://www.abstracts2view.com/endo/ 803076022 view.php?nu=ENDO12L%5fMON-185 - USA
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Reactions 25 Aug 2012 No. 1416
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