Endocrine and Metabolic Disorders Lectures 8 I.Kuziv, MD, PhD

Endocrine and Metabolic Endocrine and Metabolic DisordersDisorders

Lectures 8I.Kuziv, MD, PhD

Diabetes MellitusDiabetes MellitusChanging insulin needs during pregnancyChanging insulin needs during pregnancy

Diabetes MellitusDiabetes MellitusAntepartum careAntepartum care Insulin TherapyInsulin Therapy

lthough subcutaneous insulin injections are most commonly used, lthough subcutaneous insulin injections are most commonly used, continuous insulin infusion systems may be used during pregnancy. continuous insulin infusion systems may be used during pregnancy. The insulin pump is designed to mimic more closely the function of the The insulin pump is designed to mimic more closely the function of the pancreas in secreting insulin (Fig. 3). This portable, battery-powered pancreas in secreting insulin (Fig. 3). This portable, battery-powered device infuses regular insulin at a set basal rate and has the capacity device infuses regular insulin at a set basal rate and has the capacity to deliver up to four different basal rates in 24 hours. The pump also to deliver up to four different basal rates in 24 hours. The pump also delivers bolus doses of insulin before meals to control postmeal blood delivers bolus doses of insulin before meals to control postmeal blood glucose levels. The infusion tubing from the insulin pump can be left in glucose levels. The infusion tubing from the insulin pump can be left in place for several weeks without local complications. Although the place for several weeks without local complications. Although the insulin pump is convenient and generally provides good glycemic insulin pump is convenient and generally provides good glycemic control, complications such as DKA, infection, or hypoglycemic coma control, complications such as DKA, infection, or hypoglycemic coma can still develop. Use of the insulin pump requires a knowledgeable, can still develop. Use of the insulin pump requires a knowledgeable, motivated pa tient; skilled health care providers; and 24-hour availability motivated pa tient; skilled health care providers; and 24-hour availability of emergency assistanceof emergency assistance

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