{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T16:01:47Z","timestamp":1789056107940,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,12,10]],"date-time":"2018-12-10T00:00:00Z","timestamp":1544400000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet. Med."],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Marked hyperglycaemia is common following betamethasone administration in women with gestational diabetes (GDM), and may contribute to neonatal hypoglycaemia. Validated protocols to deliver glycaemic stability following betamethasone are lacking. We hypothesized that an intravenous insulin (IVI) protocol for pregnancy\u2010specific glycaemic targets (Pregnancy\u2010IVI) would achieve greater at\u2010target glycaemic control than a generic adult intravenous insulin protocol (Adult\u2010IVI), and may reduce neonatal hypoglycaemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort study of the performance Adult\u2010IVI and Pregnancy\u2010IVI following betamethasone in GDM, sequentially implemented at a tertiary hospital, without change in indication for IVI. Cases were identified by electronic record search. Primary outcome was percentage of on\u2010IVI time with at\u2010target glycaemia [blood glucose level (BGL) 3.8\u20137\u00a0mmol\/l]. Secondary outcomes were time with critical hyperglycaemia (BGL &gt;\u00a010\u00a0mmol\/l), occurrence of maternal hypoglycaemia (BGL &lt;\u00a03.8\u00a0mmol\/l), and incidence of neonatal hypoglycaemia (BGL \u2264\u00a02.5\u00a0mmol\/l) if betamethasone was administered within 48\u00a0h of birth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The cohorts comprised 151 women (Adult\u2010IVI <jats:italic>n<\/jats:italic>\u00a0=\u00a086; Pregnancy\u2010IVI <jats:italic>n<\/jats:italic>\u00a0=\u00a065). The primary outcome was 68% time\u2010at\u2010target [95% confidence interval (CI) 64\u201371%) for Pregnancy\u2010IVI compared with 55% (95% CI 50\u201360%) for Adult\u2010IVI (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.0002). Critical maternal hyperglycaemia (0% vs. 2%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.02) and hypoglycaemia (2% vs. 12%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.02) were both lower with Pregnancy\u2010IVI than Adult\u2010IVI. Neonatal hypoglycaemia was less common after Pregnancy\u2010IVI (29%) than after Adult\u2010IVI (54%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.03). A multiple logistic regression model adjusting for potential confounders gave an odds ratio for neonatal hypoglycaemia with Pregnancy\u2010IVI of 0.27 (95% CI 0.10\u20130.76, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>An IVI protocol designed for pregnancy effectively controlled maternal hyperglycaemia following betamethasone administration in GDM. This is the first intervention to show a reduction in betamethasone\u2010associated neonatal hypoglycaemia, linked with optimum maternal glycaemic control.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.13864","type":"journal-article","created":{"date-parts":[[2018,11,16]],"date-time":"2018-11-16T09:08:43Z","timestamp":1542359323000},"page":"228-236","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["An intravenous insulin protocol designed for pregnancy reduces neonatal hypoglycaemia following betamethasone administration in women with gestational diabetes"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9652-6562","authenticated-orcid":false,"given":"C. W.","family":"Rowe","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Diabetes John Hunter Hospital Newcastle Australia"},{"name":"School of Medicine and Public Health University of New castle Newcastle Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Putt","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Diabetes John Hunter Hospital Newcastle Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Brentnall","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Diabetes John Hunter Hospital Newcastle Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Gebuehr","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Diabetes John Hunter Hospital Newcastle Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Allabyrne","sequence":"additional","affiliation":[{"name":"Department of Maternity and Gynaecology John Hunter Hospital Newcastle Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Woods","sequence":"additional","affiliation":[{"name":"School of Medicine and Public Health University of New castle Newcastle Australia"},{"name":"Department of Maternity and Gynaecology John Hunter Hospital Newcastle Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Wynne","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Diabetes John Hunter Hospital Newcastle Australia"},{"name":"School of Medicine and Public Health University of New castle Newcastle Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,12,10]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0707943"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-159-2-201307160-00661"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpendo.1985.249.5.E454"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1203\/00006450-198709000-00023"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(82)92227-9"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1982.tb04630.x"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(87)80075-3"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1004939"},{"key":"e_1_2_9_10_1","first-page":"909","article-title":"Does fetal acidosis develop with maternal glucose infusion during normal labor?","volume":"74","author":"Piquard F","year":"1989","journal-title":"Obstet Gynecol"},{"key":"e_1_2_9_11_1","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1542\/peds.44.5.668","article-title":"Human fetal insulin response after acute maternal glucose administration during labor","volume":"44","author":"Tobin JD","year":"1969","journal-title":"Pediatrics"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(72)90682-5"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(80)90619-4"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1985.tb10963.x"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-999750"},{"key":"e_1_2_9_16_1","first-page":"113","article-title":"Relative effects of antepartum and intrapartum maternal blood glucose levels on incidence of neonatal hypoglycemia","volume":"17","author":"Curet LB","year":"1997","journal-title":"J Perinatol"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.1990.tb01352.x"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-200204000-00004"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13337"},{"key":"e_1_2_9_20_1","unstructured":"DashoraU TempleR MurphyH.JBDS12: Management of Glycaemic Control in Pregnant Women with Diabetes on Obstetric Wards and Delivery Units. Joint British Diabetes Societies for Inpatient Care Group (JBDS\u2010IP). Available athttp:\/\/www.diabetologists-abcd.org.uk\/JBDS\/JBDS_Pregnancy_final_18082017.pdfLast accessed 23 August 2018."},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.2009.00969.x"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(95)90222-8"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/1520-6661(200009\/10)9:5<273::AID-MFM3>3.0.CO;2-N"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1516783"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-5491.2003.01026_21_3.x-i1"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0412.2002.810906.x"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-5491.2003.00853.x"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.EJ15-0482"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13799"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2010.0247"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13579"}],"container-title":["Diabetic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fdme.13864","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.13864","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/dme.13864","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.13864","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T11:32:42Z","timestamp":1694691162000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dme.13864"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12,10]]},"references-count":30,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2019,2]]}},"alternative-id":["10.1111\/dme.13864"],"URL":"https:\/\/doi.org\/10.1111\/dme.13864","archive":["Portico"],"relation":{},"ISSN":["0742-3071","1464-5491"],"issn-type":[{"value":"0742-3071","type":"print"},{"value":"1464-5491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12,10]]},"assertion":[{"value":"2018-11-14","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-12-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}