Effect of antenatal betamethasone on blood glucose levels in women with and without diabetes

- Both diabetic and nondiabetic subjects demonstrate hyperglycemia after receipt of betamethasone.
- Women with higher BMIs had lower time of hyperglycemia.
- Consideration should be given to monitoring the glycemic response in nondiabetics after betamethasone administration.

ObjectiveTo characterize the maternal glycemic response to betamethasone in subjects without diabetes compared to subjects with diabetes.Study designBlood glucose levels in 22 gravidae without diabetes and 11 gravidae with diabetes were recorded for 48 h following betamethasone administration for threatened preterm delivery. Maximum blood glucose value and time to maximum value were compared. Area under the curve calculations were used to express the duration and degree of significant hyperglycemia for individual subjects. These summary measures were then correlated to subject characteristics and laboratory values to determine a risk profile of those subjects without diabetes at risk for significant hyperglycemia.ResultsAll subjects with diabetes and the majority of those without diabetes had significant hyperglycemia during the study period. Mean maximum blood glucose was higher for those with diabetes (205 mg/dL vs. 173 mg/dL, p ⩽ 0.01). Mean time to reach the maximum glucose level was similar for both groups. Result of a glucose tolerance test given immediately prior to betamethasone correlated strongly with amount of time spent with hyperglycemia for subjects without diabetes (rho = 0.59, p ⩽ 0.01). Morbidly obese subjects spent less time with hyperglycemia than those with lower body mass indices (p = 0.03).ConclusionBoth subjects with and without diabetes demonstrate significant hyperglycemia after receipt of antenatal betamethasone.