Insulin analogue therapy in pregnancies complicated by diabetes mellitus.
Pregnancies complicated by diabetes mellitus (DM) include pregestational DM and gestational DM, defined as carbohydrate intolerance of variable severity first detected during pregnancy. DM leads to poor pregnancy outcome. The aim of treatment is to control maternal hyperglycaemia and to imitate postprandial insulin release. Rapid-acting insulin analogues are suitable therapeutic candidates, as they are able to reduce postprandial hyperglycaemia (predictive of adverse pregnancy outcome). There is no excess risk of adverse fetal or maternal outcomes when compared with regular insulin. Data suggest that rapid-acting insulin analogues do not transfer to human placenta. Because of the reduced risk of hypoglycaemia and improved postprandial and overall glucose control, insulin analogues could be considered the rapid-acting insulin choice during pregnancy.
González
Claudio
C
Pharmacology Department, Universidad de Buenos Aires, School of Medicine, Argentina.
Santoro
Silvina
S
Salzberg
Susana
S
Di Girolamo
Guillermo
G
Alvariñas
Jorge
J
D016640:Diabetes, Gestational / Q000097:blood / Q000188:drug therapy*; D005260:Female; D005315:Fetal Diseases / Q000097:blood / Q000188:drug therapy; D006801:Humans; D007328:Insulin / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D061268:Insulin Lispro; D008429:Maternal Welfare / Q000706:statistics & numerical data; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology
D007328:Insulin; D061268:Insulin Lispro