Steroid loading
Betamethasone is given to women to promote lung maturation in the fetus. It is given prior to delivery when:
In women whose glucose levels have been poorly controlled, fetal lungs are less mature, and the neonate is at a higher risk of respiratory distress. Betamethasone is used to reduce the risk of this complication in these high risk pregnancies.
Betamethasone causes increased insulin resistance, which results in hyperglycemia that lasts for 24 – 48 hours after the 2nd injection. Typically, glucose levels are high after lunch and dinner.
The transient hyperglycemia can be offset by the following strategies:
When the glucose levels start to decrease again, return the insulin doses to the original setting before the steroids were given.
Preparing for the delivery: