Insulin Adjustment During Antenatal Steroid Treatment with
 Betamethasone  -BETA

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Hyperglycemia may occur as early as 3 to 8 hours after antenatal steroids have been given. Glucose values may be expected to  return to normal 24 hours after the second dose of betamethasone in nondiabetic patients. Pregestational and gestational diabetics on oral medication or insulin  may require, at least temporarily, doubling of their insulin doses.

The expected total daily insulin dose requirement during treatment with antenatal steroids (betamethasone) may be estimated using the calculator below. Individualize to patient response

Total Daily Dose of Insulin BEFORE Betamethasone  (Basal and bolus)       UNITS   

Expected total daily insulin dose requirement
     Day 1
First dose betamethasone  12 mg 
Day 2
Second  dose betamethasone  12 mg 
Day 3     UNITS
 Day 4     UNITS
  Day5      UNITS (revert to prebetamethasone dose)


1. Star J, Hogan J, Sosa ME, Carpenter MW. Glucocorticoid-associated maternal hyperglycemia: a randomized trial of insulin prophylaxis. J Matern Fetal Med. 2000 Sep-Oct;9(5):273-7.PMID:11132581 
And may remain elevated for up to 5 days after 
2. Mathiesen ER, et. al., Insulin dose during glucocorticoid treatment for fetal lung maturation in diabetic pregnancy: test of an algorithm [correction of analgoritm]. Acta Obstet Gynecol Scand. 2002 Sep;81(9):835-9.PMID:12225298 
3. Kalra S, Kalra B, Gupta Y. Glycemic management after antenatal corticosteroid therapy. N Am J Med Sci. 2014 Feb;6(2):71-6. doi: 10.4103/1947-2714.127744.PMID:24696828 
4 . Shields, L and Tsay, GS. Editors, California Diabetes and Pregnancy Program Sweet Success Guidelines for Care. Developed with California Department of Public Health; Maternal, Child and Adolescent Health Division; revised edition, July, 2012. Guidelines for Care, California Diabetes and Pregnancy Program,2012. p 48  


All calculations must be confirmed before use. The suggested results are not a substitute for clinical judgment. Neither nor any other party involved in the preparation or publication of this site shall be liable for any special, consequential, or exemplary

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