Use of insulin glargine during pregnancy.
BACKGROUND
Good metabolic control maintained throughout pregnancy reduces maternal and fetal complications in diabetic women. The long-acting insulin analogue glargine has 24-h persistence and a peakless action profile, and could contribute to more stable daily plasma glucose levels and improved glycemic control. We evaluated the metabolic control associated with insulin glargine during pregnancy in comparison with conventional basal insulin therapy.


METHODS
Retrospective case-control analysis of glycemic control and pregnancy complications in 100 type 1 diabetic pregnancies with intermediate-acting NPH insulin or insulin glargine prior to conception and throughout pregnancy.


RESULTS
Overall,glycemic control was not different between the groups, though the decrease in HbA1c from the first to the third trimester was greater with insulin glargine (0.8 versus 0.3%, p=0.04). The rate of hypoglycemia was comparable.


CONCLUSIONS
Our findings suggest that, as regards metabolic control, insulin glargine in women with type 1 diabetes is comparable with NPH insulin as basal insulin therapy. No adverse effects were associated with glargine use at the time of conception and during pregnancy.
Pöyhönen-Alho
Maritta
M
Department of Obstetrics and Gynecology, Helsinki University Hospital, Helsinki, Finland.
Rönnemaa
Tapani
T
Saltevo
Juha
J
Ekblad
Ulla
U
Kaaja
Risto J
RJ
D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000187:drug effects; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D000069036:Insulin Glargine; D049528:Insulin, Long-Acting / Q000627:therapeutic use*; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000188:drug therapy*; D012189:Retrospective Studies; D055815:Young Adult
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D049528:Insulin, Long-Acting; D000069036:Insulin Glargine