Rapid, patient-led titration of basal insulin can be used to achieve tight glycaemic control in gestational diabetes mellitus with insulin resistance

Isabelle Mayne; Nicholas Thomas; Andrew McGovern

doi:10.1136/bcr-2021-248533

Rapid, patient-led titration of basal insulin can be used to achieve tight glycaemic control in gestational diabetes mellitus with insulin resistance

BMJ Case Rep. 2022 Mar 10;15(3):e248533. doi: 10.1136/bcr-2021-248533.

Authors

Isabelle Mayne¹, Nicholas Thomas^{2

3}, Andrew McGovern^{2

3}

Affiliations

¹ Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK isabelle.mayne@nhs.net.
² Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK.
³ Department of Diabetes and Endocrinology, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK.

Abstract

A woman with gestational diabetes mellitus (GDM) and significant insulin resistance in her third pregnancy was diagnosed with a fasting blood glucose reading of 5.7 mmol/L (103 mg/dL) at 28+1 weeks gestation and referred to our diabetes team. Using a rapid, patient-led approach to basal insulin titration this patient achieved therapeutic doses and glucose targets in the limited time available during pregnancy, without causing significant hypoglycaemia. This method of insulin titration empowers women with GDM to take control of their own management and could reduce complications in GDM pregnancies at negligible additional cost. The only additional cost being that of the higher insulin doses used.

Keywords: diabetes; endocrine system; pregnancy.

Publication types

Case Reports

MeSH terms

Diabetes, Gestational* / diagnosis
Diabetes, Gestational* / drug therapy
Female
Glycemic Control
Humans
Hypoglycemia* / drug therapy
Insulin / therapeutic use
Insulin Resistance*
Pregnancy

Substances

Insulin