title: Comparison of Insulin Lispro Protamine Suspension with NPH Insulin in Pregnant Women with Type 2 and Gestational Diabetes Mellitus: Maternal and Perinatal Outcomes.
abstract: Insulin therapy is still the gold standard in diabetic pregnancy. Insulin lispro protamine suspension is an available basal insulin analogue. Aim. To study pregnancy outcomes of women with type 2 and gestational diabetes mellitus when insulin lispro protamine suspension or human NPH insulin was added to medical nutrition therapy and/or short-acting insulin. Methods. In this retrospective study, for maternal outcome we recorded time and mode of delivery, hypertension, glycaemic control (fasting blood glucose and HbA1c), hypoglycemias, weight increase, and insulin need. For neonatal outcome birth weight and weight class, congenital malformations was recorded and main neonatal complications. Two-tail Student's t-test and chi-square test were performed when applicable; significant P < 0.05. Results. Eighty-nine pregnant women (25 with type 2 diabetes and 64 with gestational diabetes mellitus; 53 under insulin lispro protamine suspension and 36 under human NPH insulin) were recruited. Maternal and neonatal outcomes were quite similar between the two therapeutic approaches; however, insulin need was higher in NPH. At the end of pregnancy, eight women with gestational diabetes continued to use only basal insulin analogue. Conclusions. Pregnancy outcome in type 2 and gestational diabetes mellitus with insulin lispro protamine suspension was similar to that with NPH insulin, except for a lower insulin requirement.
authors.affiliation: Department of Clinical and Molecular Medicine, S. Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University, Via di Grottarossa 1035-1039, 00189 Rome, Italy.
authors.forename: Antonietta
authors.initials: A
authors.lastname: Colatrella
authors.forename: Natalia
authors.initials: N
authors.lastname: Visalli
authors.forename: Santina
authors.initials: S
authors.lastname: Abbruzzese
authors.forename: Sergio
authors.initials: S
authors.lastname: Leotta
authors.forename: Marzia
authors.initials: M
authors.lastname: Bongiovanni
authors.forename: Angela
authors.initials: A
authors.lastname: Napoli