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임신한 당뇨환자에서 인슐린 lispro 투여로 저혈당을 예방한 2 예 보고
임문환(Moon Whan Im),박운호(Un Ho Park),이정은(Jung Eun Lee),고선환(Sun Hwan Koh),임수빈(Soo Bin Im),이정례(Jeong Rye Lee),이지영(Ji Young Lee),황성욱(Sung Ook Hwang),이우영(Woo Young Lee) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.7
Insulin therapy is indicated in the treatment of gestational diabetic women and overt diabetic pregnant women for hyperglycemia after failure to respond to the diets and exercise regimens. The insulin is administered to mimic normal pancreatic function. The normal pancreas secretes 50% of the total daily insulin as mealtime boluses. This delivery may be mimicked by four-injection-per-day of combination of NPH and regular insulin (RI). Hypoglycemia is a well-recognized complication of intensive insulin therapy in patients with Type Ⅱ diabetes. Recently, it has been reported that insulin-lispro, an analogue of regular human insulin with a peak insulin action achieved with a 1 hour after injection improves postprandial glucose concentration in non-pregnant diabetic patients. Treatment of gestational or diabetic pregnant women with NPH and insulin-lispro has significantly lower postprandial glucose levels without an increase in hypoglycemic events. Here, we report 2 cases of hyperglycemic control with four times daily administration of NPH & insulin-lispro on diabetes in pregnancy, with brief reviews.