Evaluation of steroid effects on glucose and ketone levels in women with diabetes mellitus in pregnancy using novel glucose monitoring devices.

Participants will receive 2 doses of IM betamethasone 11.4mg 24 hours apart by the nurse in charge. Each participant will have a Flash glucose monitoring and a continuous glucose monitoring device inserted on the day of admission, prior to IM betamethasone administration. The glucose monitoring devices will be inserted by the study team member. The FGM device will be inserted into the upper outer aspect of the arm, while the CGM device will be inserted on the lower abdomen. This will be in addition to hourly capillary glucose monitoring which is part of routine care, which commences after betamethasone administration. On day 2 of admission, the participants will have hourly venous blood drawn for glucose and ketones levels. 4 hourly urine ketones will also be collected on this day. IV insulin infusion will be initiated during hospitalisation, as per standard protocol/ medical care, with the rates adjusted according to the hourly capillary blood glucose readings. The IV insulin infusion can be initiated from day 2 of admission or earlier if blood glucose levels are high prior to IM betamethasone administration. Participants will be monitored till day after the second dose of IM betamethasone or until delivery, depending on Obstetrics indication. Hourly blood draws/ urine tests for the study will only be for the 2nd day after steroid use. Participants are encouraged to contInue the use of FGM/ CGM devices while hospitalized and on discharge (or till delivery)- maximum wear of 6 days for CGM and 2 weeks for FGM. The accuracy of interstitial glucose levels as monitored by the flash glucose monitoring and continuous glucose monitoring devices will be compared against venous glucose retrospectively.