{
  "abstract": "Background: Antenatal corticosteroids (ACS) promote foetal lung maturation in pregnancies at risk of preterm birth; however, in gestational diabetes mellitus (GDM), they can exacerbate maternal glycemia and contribute to adverse neonatal outcomes. Clinical guidelines offer limited direction on optimal treatment adjustment.\n\nObjectives: To synthesize the evidence on glycaemic responses and management strategies following ACS exposure in individuals with GDM.\n\nMethods: A systematic review of Embase, MEDLINE and CENTRAL in October 2025 in accordance with PRISMA guidelines. Studies reporting on glycaemic outcomes and/or management strategies following ACS exposure in individuals with GDM were included.\n\nResults: Twenty studies were included. Maternal glycemia rose predictably after ACS, with hyperglycaemia typically emerging within 9–16 h, peaking over the subsequent 24–72 h and often persisting up to 5 days. Among individuals managed with medical nutrition therapy or oral hypoglycaemic agents at baseline, insulin initiation ranged from 13% to 91%. Among those already using insulin, 67%–88% required dose escalation, with mean increases typically ranging from 47% to 91%. Pregnancy‐adapted intravenous insulin (IVI) pathways reported higher time‐in‐range and fewer hyperglycaemic/hypoglycaemic events than adult IVI protocols. However, emerging evidence suggests that structured, pregnancy‐specific subcutaneous insulin protocols may achieve comparable or improved glycaemic control.\n\nConclusions: ACS exposure in GDM is associated with a predictable but variable, transient deterioration in maternal glycaemia. GDM‐specific evidence suggests that structured pregnancy‐adapted monitoring and insulin‐adjustment pathways may help attenuate post‐ACS hyperglycaemia. However, the evidence remains heterogeneous and largely observational. Prospective studies are needed to validate GDM‐specific algorithms, clarify thresholds for insulin initiation or escalation and define indications for subcutaneous versus IVI.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Medicine McGill University Montreal Quebec Canada",
    "Faculty of Medicine Université de Montréal Montreal Quebec Canada",
    "Faculty of Medicine Université de Sherbrooke Sherbrooke Quebec Canada",
    "Faculty of Medicine McGill University Montreal Quebec Canada",
    "Division of Endocrinology and Metabolism McGill University Health Centre Montreal Quebec Canada",
    "Division of Endocrinology and Metabolism Jewish General Hospital Montreal Quebec Canada",
    "Division of Endocrinology and Metabolism Centre hospitalier de l'Université de Montréal (CHUM) and Research Center of the Centre hospitalier de l'Université de Montréal (CR‐CHUM) Montreal Quebec Canada",
    "Centre for Outcomes Research and Evaluation Research Institute of the McGill University Health Centre Montreal Quebec Canada",
    "School of Human Nutrition McGill University Montreal Quebec Canada",
    "Lady Davis Institute for Medical Research, Centre for Clinical Epidemiology McGill University Montreal Quebec Canada"
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 12,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Alexandra Katz",
      "orcid": "0000-0002-7137-6393"
    },
    {
      "affs": [
        1
      ],
      "name": "Aidan Shulkin"
    },
    {
      "affs": [
        2
      ],
      "name": "Samantha Jacobson"
    },
    {
      "affs": [
        3
      ],
      "name": "Chella Price"
    },
    {
      "affs": [
        0,
        4
      ],
      "name": "Michael A. Tsoukas",
      "orcid": "0000-0002-8326-7274"
    },
    {
      "affs": [
        0,
        4
      ],
      "name": "Isabella Albanese"
    },
    {
      "affs": [
        0,
        5
      ],
      "name": "Agnieszka Majdan"
    },
    {
      "affs": [
        0,
        5
      ],
      "name": "Jill Pancer"
    },
    {
      "affs": [
        6
      ],
      "name": "Ariane Godbout"
    },
    {
      "affs": [
        0,
        7
      ],
      "name": "Kaberi Dasgupta",
      "orcid": "0000-0002-2447-3553"
    },
    {
      "affs": [
        8
      ],
      "name": "Anne‐Sophie Brazeau",
      "orcid": "0000-0002-2699-2920"
    },
    {
      "affs": [
        0,
        5,
        9
      ],
      "name": "Tricia Peters"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/fea2n69pfaxn7.bib",
  "cited_by": 0,
  "doi": "10.1111/dom.71311",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13731064/",
  "id": "fea2n69pfaxn7",
  "issns": [
    "1462-8902",
    "1463-1326"
  ],
  "landing_url": "https://doi.org/10.1111/dom.71311",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Review Article"
    ],
    [
      "openalex",
      "2729|Gestational Diabetes Research and Management"
    ]
  ],
  "openalex": "W7212157320",
  "pdf_url": "https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/dom.71311",
  "pmcid": "PMC13731064",
  "pmid": "42717529",
  "published": "2026-09-09",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/fea2n69pfaxn7.ris",
  "sources": [
    {
      "first_seen": "2026-11-08T12:21:19Z",
      "native_id": "PMC13731064",
      "source": "pmc",
      "url": "https://doi.org/10.1111/dom.71311"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2729|Gestational Diabetes Research and Management",
      "subfield": "reproductive-child"
    }
  ],
  "title": "Antenatal Corticosteroids in Gestational Diabetes: A Systematic Review of Glycemic Response and Management Strategies",
  "title_text": "Antenatal Corticosteroids in Gestational Diabetes: A Systematic Review of Glycemic Response and Management Strategies",
  "type": "peer-reviewed",
  "updated_at": "2026-11-08T12:21:19Z",
  "url": "https://research.draconitic.com/paper/fea2n69pfaxn7",
  "venue": "Diabetes, Obesity & Metabolism",
  "versions": []
}