インスリン持続皮下注入法(CS2)により長期血糖の正常化とインスリン抗体の減少を可能とした糖尿病妊婦の1例

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In this report, we examine the case of a 26-year-old unstable diabetic woman who had lost a baby 2 years previously by intrauterine fetal death in the 32 th gestational week. Her diabetic control by conventional insulin treatment was aggravated during the second pregnancy, we attempted to treat her by Continuous Subcutaneous Insulin Infusion (CSII) with a portable pump. Although the total daily insulin dose required was 44% less than the conventional dose used before CSII, a marked improvement in blood glucose control was achieved (MBG, M-value, MAGE all were improved) and glycosylated hemoglobin level was normalized. Furthermore, the high level of insulin antibodies in the conventional treatment rapidly fell after CSII (NSB 32% VS 11%) . The proportion of the total daily insulin dose delivered as basal insulin remained unchanged throughout the pregnancy (50-55%) . After her discharge, she experienced no hypoglycemic attacks, and the course of her pregnancy was normal. We conclude that CSII is a highly efficient way to achieve normal blood glucose levels in a brittle diabetic during pregnancy, and also effective in reducing insulin antibodies.
学校法人昭和大学・昭和医学会の論文