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Insulin lispro and regular insulin in pregnancy
A Bhattacharyya1, S Brown, S Hughes
1Department of Medicine, Division of Diabetes, Preston Acute Hospital NHS Trust, Preston, UK. arpandev@aol.com
Summary
Insulin lispro is safe for diabetic pregnancies, showing no increased adverse outcomes compared to regular insulin. Patients reported higher satisfaction with insulin lispro, indicating a potential preference for this treatment in managing diabetes during pregnancy.
Area of Science:
- Obstetrics and Gynecology
- Endocrinology
- Pharmacology
Background:
- Diabetes mellitus in pregnancy, including gestational, type 1, and type 2, poses risks to maternal and fetal health.
- Insulin therapy is crucial for glycemic control in these pregnancies.
- Insulin lispro, a rapid-acting insulin analog, offers potential benefits in mealtime glucose management.
Purpose of the Study:
- To assess the safety and efficacy of insulin lispro compared to regular insulin in pregnancies complicated by diabetes.
- To evaluate maternal and fetal outcomes in women with gestational, type 1, and type 2 diabetes treated with insulin lispro.
- To determine patient satisfaction with insulin lispro versus regular insulin during pregnancy.
Main Methods:
- A retrospective analysis of 635 pregnancies over 7 years involving insulin lispro and regular insulin.
- Comparison of maternal and fetal outcomes, including pregnancy loss and congenital anomalies.
- Administration of an anonymous diabetes treatment satisfaction questionnaire to 22 patients.
Main Results:
- No significant difference in maternal or fetal outcomes between insulin lispro and regular insulin in gestational diabetes.
- Lower pre-delivery HbA1c levels observed with insulin lispro in gestational diabetes.
- Higher patient satisfaction reported with insulin lispro compared to regular insulin (p=0.0005).
Conclusions:
- Insulin lispro is a safe alternative to regular insulin in diabetic pregnancies, with no increase in adverse maternal or fetal outcomes.
- Insulin lispro use is associated with improved glycemic control (lower HbA1c) and higher patient satisfaction.
- The findings support the use of insulin lispro for managing diabetes during pregnancy, particularly for patients seeking enhanced satisfaction and control.