Insulin and diabetic in labor

rUmad2 · Oct 12, 2004

How many automatically run IV insulin and dextrose on diabetics (on insulin) in labor? I have read the ACOG guidelines but after surveying hospitals in my area, it seems many still give insulin subq, check capillary glucose frequently and have dextrose for IV push if needed.

Thanks!

Beth

SmilingBluEyes · Oct 12, 2004

AUTOMATICALLY? Nope, not unless they are brittle and in trouble do we do that. They get drips ONLY if their PRN insulin is not doing the trick. Watch those on drips, they can be VERY labile---believe me! We have to have to accucheck them Q1H when on drips. Sometimes it's not even that long before instability begins.......have the oral glucose or D50 ready !!!!! Titrating insulin drips is a real trick and a real pain. Maybe you are not checking them often enough for proper titration!

Deb

rUmad2 · Oct 12, 2004

Thanks for the response! We have had GREAT control with subq....we have diabetic educators who have good intentions but are trying to make IV insulin our "standard" and insist we use is it all IDDM patients in labor--in good control or not. Thanks again for your response which supports my opinion completely!!

Beth

AUTOMATICALLY? Nope, not unless they are brittle and in trouble do we do that. They get drips ONLY if their PRN insulin is not doing the trick. Watch those on drips, they can be VERY labile---believe me! We have to have to accucheck them Q1H when on drips. Sometimes it's not even that long before instability begins.......have the oral glucose or D50 ready !!!!! Titrating insulin drips is a real trick and a real pain. Maybe you are not checking them often enough for proper titration!
Deb