title: Insulin glargine versus neutral protamine Hagedorn insulin for treatment of diabetes in pregnancy.
abstract: We compared maternal and neonatal outcomes in diabetic pregnancies treated with either insulin glargine or neutral protamine Hagedorn (NPH) insulin. We performed a retrospective chart review of diabetic pregnant patients using the Diabetes Care Center of Wake Forest University during the years 2000 to 2005. Outcomes of interest included maternal hemoglobin A1C, average fasting and 2-hour postprandial blood sugars, mode of delivery, birth weight, 5-minute Apgar score < 7, umbilical artery pH < 7.20, incidence of neonatal hypoglycemia, and pregnancy complications. A total of 52 diabetic pregnant patients were included in this study. Twenty-seven women used insulin glargine. A total of 13 women used insulin glargine during the first trimester. Glycemic control was similar in women who used NPH insulin and insulin glargine, as determined by hemoglobin A1C levels and mean blood sugar values. There were no differences in mode of delivery, average birth weight, or neonatal outcomes. Maternal and fetal/neonatal outcomes appear similar in pregnant diabetic women who use either NPH insulin or insulin glargine in combination with a short-acting insulin analogue to achieve adequate glycemic control during pregnancy. Insulin glargine appears to be an effective insulin analogue for use in women whose pregnancies are complicated by diabetes.
authors.affiliation: Department of Obstetrics and Gynecology, Section on Maternal Fetal Medicine, Wake Forest University School of Medicine, Winston Salem, North Carolina, USA. jgsmith@wfubmc.edu
authors.forename: Jennifer G
authors.initials: JG
authors.lastname: Smith
authors.forename: Tracy A
authors.initials: TA
authors.lastname: Manuck
authors.forename: Jenifer
authors.initials: J
authors.lastname: White
authors.forename: David C
authors.initials: DC
authors.lastname: Merrill
mesh_terms: D000328:Adult; D001034:Apgar Score; D001724:Birth Weight; D001786:Blood Glucose / Q000032:analysis; D002245:Carbon Dioxide / Q000097:blood; D036861:Delivery, Obstetric; D016640:Diabetes, Gestational / Q000097:blood / Q000188:drug therapy; D004435:Eating; D005215:Fasting; D005260:Female; D005865:Gestational Age; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007003:Hypoglycemia / Q000175:diagnosis; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007231:Infant, Newborn / Q000097:blood; D007328:Insulin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000069036:Insulin Glargine; D007336:Insulin, Isophane / Q000627:therapeutic use*; D049528:Insulin, Long-Acting; D010100:Oxygen / Q000097:blood; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D011254:Pregnancy in Diabetics / Q000097:blood / Q000188:drug therapy*; D012189:Retrospective Studies; D014469:Umbilical Arteries / Q000502:physiology; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D002245:Carbon Dioxide; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D000069036:Insulin Glargine; D007336:Insulin, Isophane; D049528:Insulin, Long-Acting; D010100:Oxygen