Perinatal outcomes in pregnancies managed with antenatal insulin glargine

Author(s): Egerman RS, Ramsey RD, Kao LW, Bringman JJ, Haerian H, et al.


We compared perinatal outcomes in pregnancies in which insulin glargine was used in the management of patients with pregnancies in which standard insulin therapy was used at a single institution. A retrospective analysis of 114 pregnant patients with diabetes (pregestational or gestational) managed at a single center between January 2004 and August 2006 was undertaken. Sixty-five patients managed with insulin glargine were compared with 49 patients managed with neutral protamine Hagedorn (NPH) insulin. Both groups were also treated with short-acting insulin (either regular, lispro, or aspart insulin). Maternal age, parity, prepregnancy weight, body mass index, duration of diabetes, hemoglobin A (1C) (at entry and final recorded) and gestational age at entry were similar for each group (glargine and NPH). Thirty patients had gestational diabetes (18 glargine and 12 NPH); there were no differences in numbers of patients in higher-order White's classification between the two groups. Cesarean section for obstetric reasons included labor abnormalities, malpresentation, fetal distress, and suspected macrosomia. There were no differences in gestational age at delivery, birth weight, preeclampsia, or frequency of cesarean section (total or for obstetric reasons). The frequency of shoulder dystocia was higher in the NPH group. Regarding neonatal outcomes, gestational age at delivery, birth weight, Apgar scores, admission to the neonatal intensive care unit, respiratory distress syndrome, hypoglycemia, and congenital anomalies were similar between the two groups. From this retrospective analysis, no adverse maternal or neonatal effects were seen from maternal administration of insulin glargine. A larger multicenter study is needed to confirm these findings. This preliminary report suggests that use of insulin glargine during pregnancy can be considered if maternal metabolic control is suboptimal using the standard split-mix regimen.

Similar Articles

Less hypoglycemia with insulin glargine in intensive insulin therapy for type 1 diabetes

Author(s): Ratner RE, Hirsch IB, Neifing JL, Garg SK, Mecca TE, et al.

Insulin analogues and their potential in the management of diabetes mellitus

Author(s): Bolli GB, Di Marchi RD, Park GD, Pramming S, Koivisto VA

Meta-analysis of the effect of insulin lispro on severe hypoglycemia in patients with type 1 diabetes

Author(s): Brunelle BL, Llewelyn J, Anderson JH Jr, Gale EA, Koivisto VA

Prevention of perinatal morbidity by tight metabolic control in gestational diabetes mellitus

Author(s): Drexel H, Bichler A, Sailer S, Breier C, Lisch HJ, et al.

Correlations of receptor binding and metabolic and mitogenic potencies of insulin analogs designed for clinical use

Author(s): Kurtzhals P, Schäffer L, Sørensen A, Kristensen C, Jonassen I, et al.

Use of insulin glargine during pregnancy in a type 1 diabetic woman

Author(s): Devlin JT, Hothersall L, Wilkis JL

Insulin glargine use during pregnancy

Author(s): Pantalone KM, Faiman C, Olansky L

Perinatal outcomes associated with the use of glargine during pregnancy

Author(s): Di Cianni G, Torlone E, Lencioni C, Bonomo M, Di Benedetto A, et al.