[Two consecutive pregnancies in a type 1 diabetic under treatment with insulin Lispro].
BACKGROUND
Glucose control is mandatory in pregnant women with type 1 diabetes to keep the incidence of malformations and complications low. Insulin Lispro is a new and popular fast-acting insulin analog used for intensified insulin therapy. Although popular among young patients, this drug has not been licensed for use in pregnancy due to a possibly increased risk of fetal malformations.


METHODS
Retrospectively, the case of a 34-year-old woman with diabetes type 1, gravid III and para III, which carried her second and third child full time under Lispro treatment, was analyzed. We performed an interview of the patient and her doctors. Additionally, the pregnancy documents along with the examination documents of the children, our patient files, and the blood glucose documentation were investigated. Contrary to the first pregnancy which was carried out in the absence of Lispro (first degree hip dysplasia), both subsequent pregnancies were completely normal despite continuous Lispro therapy. HbA(1c) values in the range of 4.9-5.9% showed an adequate glucose control throughout these pregnancies.


CONCLUSIONS
This case supports the hypothesis that insulin Lispro which is highly popular among young patients can safely and effectively be used in pregnancies. In order to be able to adequately assess possible risks associated with this application, additional cases need to be documented and analyzed.
Medizinische Klinik I, Endocrinology/Angiologie, Zentrum der Inneren Medizin I, Johann Wolfgang Goethe-Universität, Frankfurt am Main. Sandra.Ahlbach@kgu.de
Sandra
S
Ahlbach
Klaus-Henning
KH
Usadel
Klaus
K
Badenhoop
D000014:Abnormalities, Drug-Induced / Q000097:blood / Q000209:etiology; D001786:Blood Glucose / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007231:Infant, Newborn; D007328:Insulin / Q000008:administration & dosage* / Q000009:adverse effects / Q000031:analogs & derivatives*; D061268:Insulin Lispro; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000097:blood / Q000188:drug therapy*; D012306:Risk
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin; D061268:Insulin Lispro