Insulin action and pharmacokinetics in insulin treated diabetics during the third trimester of pregnancy |
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Authors: | R S Gray P Cowan J M Steel F D Johnstone B F Clarke L J Duncan |
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Affiliation: | Diabetic Outpatient Department, Royal Infirmary, Edinburgh, Scotland. |
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Abstract: | Insulin action and pharmacokinetics were compared, using the euglycaemic insulin clamp technique, in seven insulin-treated diabetics during the third trimester of pregnancy and one to three weeks post-partum. At an insulin infusion rate of 1 mU/kg/min, insulin mediated glucose disposal was significantly greater (p less than 0.02) following delivery (1.194 +/- 0.138 mmol/m2/min) than in pregnancy (0.761 +/- 0.072 mmol/m2/min) and the rate of decline in insulin mediated glucose disposal, at the end of the insulin infusion, was significantly greater (p less than 0.02) following delivery (24.78 +/- 4.22 mumol/m2/min2) than in pregnancy (15.17 +/- 2.00 mumol/m2/min2). The metabolic clearance rate, distribution space and pharmacological half-life of insulin were not significantly altered by pregnancy. These findings show that the third trimester of pregnancy is associated with steady state insulin resistance accompanied by a reduced rate of insulin deactivation, but normal insulin pharmacokinetics. |
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Keywords: | Euglycaemic insulin clamp Pregnancy Insulin pharmacokinetics Diabetes mellitus |
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