Gestational diabetes & diabetes in pregnancy
A Diabetes Management Protocol with Subcutaneous Insulin During Induced Labor and Delivery in Women with Type 1 or Type 2 Diabetes
Authors' conclusion
Following a diabetes management protocol with subcutaneous insulin during induction and active labor, glucose control was close to target, with low prevalence of maternal and neonatal hypoglycemia.
Study context
- Population
- Women with T1D or insulin-treated T2D undergoing induction of labor
- Participants
- 113 women
- Comparison
- T1D vs T2D under a subcutaneous insulin diabetes management protocol
- T1Dn = 85
- T2Dn = 28
- Primary endpoint
- Maternal glucose control and neonatal outcomes
Methodological detailsTarget glucose 4.0-7.0 mmol/L from onset of active labor with IV glucose infusion (3 g/h); MDI users stopped routine insulin, nonautomated pump users continued basal insulin; supplemental insulin if above target
- Target glucose 4.0-7.0 mmol/L from onset of active labor with IV glucose infusion (3 g/h); MDI users stopped routine insulin, nonautomated pump users continued basal insulin; supplemental insulin if above target
Primary result
As reported in the abstract
Mean glucose during active labor (sensor glucose in T1D; BGM in T2D)
Further findings
HbA1c at 35 weeks
- HbA1c, mean ± SD, in the order the abstract prints them (85 T1D and 28 T2D)
- 42 ± 5 and 41 ± 10 mmol/mol (6.0 ± 2.0% and 5.9 ± 2.0%)
- The abstract does not name the group for each value.
Duration of glucose infusion
- Glucose infusion duration, median (IQR), in the order the abstract prints them
- 4.8 (2.0-7.0) and 5.5 (4.0-8.0) hours
- The abstract does not name the group for each value.
Supplemental insulin during active labor
- Supplemental insulin given, % (dose, median [IQR]), in the order the abstract prints them
- 35% (4.0 IU [2.0-7.5]) and 18% (2.0 IU [2.0-4.0])
- The abstract does not name the group for each value.
Safety
Maternal hypoglycemia (≤3.9 mmol/L [70 mg/dL]) · active labor
- Maternal hypoglycemia, in the order the abstract prints them
- 6% and 11%
- The abstract does not name the group for each value.
Neonatal hypoglycemia (<2.2 mmol/L [40 mg/dL])
- Neonatal hypoglycemia, in the order the abstract prints them
- 12% and 4%
- The abstract does not name the group for each value.
Original publication
A Diabetes Management Protocol with Subcutaneous Insulin During Induced Labor and Delivery in Women with Type 1 or Type 2 Diabetes. Diabetes Technol Ther. Published 9 July 2026. doi:10.
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