Decreasing Insulin Requirements in Pregnancy With Pre-existing or Gestational Diabetes: Management Practices Across Canada |
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| Affiliation: | 1. École d’épidémiologie et de santé publique, Université d''Ottawa, Ottawa, Ont.;2. Institut de Recherche Bruyère, Ottawa, Ont.;3. VPH Action Globale/HPV Global Action, Canada;4. École de santé publique, Université de Montréal, Montréal, Qc;1. Department of Obstetrics and Gynaecology, Mount Sinai Hospital, Toronto, ON;2. Faculty of Medicine, University of Toronto, Toronto, ON;3. Department of Obstetrics and Gynecology, St. Michael''s Hospital, Mississauga, ON;4. Faculty of Health Sciences, McMaster University, Hamilton, ON;5. Department of Obstetrics and Gynecology, St. Michael''s Hospital, Toronto, ON |
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| Abstract: | Decreasing insulin requirements in pregnant women with preexisting or gestational diabetes has been attributed to placental insufficiency, which results in increased surveillance or early delivery. This practice is not evidence based. A 5-item questionnaire was administered electronically to a convenience sample of Canadian resident and staff obstetrician-gynaecologists and maternal–fetal medicine specialists. Practice patterns varied widely among the 142 survey respondents, and this variation did not correlate to their level of training. There is a paucity of evidence to guide the management of patients with decreasing insulin requirements, which is reflected in varied and possibly unnecessary clinical interventions. |
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