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Diabetes Midwives

Sliding scales used both in labour and for steroids

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slSliding scale insulin for steroid treatment and labouring woman

Up to Sliding scales used both in labour and for steroids
March 25. 2011
Sooi-Mai Jones

Dear Mandy

Have a look at latest document -Guidelines in Managing woemen with diabetes. This experienced diabetologist view on steroid treatment is that it will have a drastic effect on blood glucose level. Therefore the sliding scale regime is different to the regime for labouring woman. 

Sooi-mai

June 12. 2013
suzannah kelly

hi

we dont use sliding scales for the administration of steroids, as we all know sliding scale regimes work best if the woman isnt eating, and we cant starve women for 2 days. we use a seperate protocol which is basically;

1. monitor blood glucose levels 4 hourly from first steroid until 24 hours after 2nd steroid.

2. continue normal insulin regime but in ADDITTION TO;

a. if 4hrly glucose if above 10mmol give stat dose of 10 units novorapid ( or usual fast acting insulin)

b. if 4hrly glucose is above 15mmol give stat dose of 15 units novorapid.

3. if 2 consequetive 4hrly readings are above 15mmol, then check venous bicarb.

4. if bicarb is less 20, start sliding scale

 

we hardly have any women who require a sliding scale which is kinder on them and actually gives the diabetes control back to the women.

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