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Insulin glargine use during pregnancy
Kevin M Pantalone1, Charles Faiman, Leann Olansky
1Endocrinology and Metabolism Institute, Cleveland Clinic, Cleveland, OH, USA. pantalk@ccf.org
Insulin glargine use in pregnancy is safe, showing no increased mitogenicity or significant placental transfer. Improved glycemic control benefits likely outweigh unproven risks for pregnant individuals with diabetes.
Area of Science:
- Endocrinology
- Pharmacology
- Maternal-Fetal Medicine
Background:
- Diabetes in pregnancy requires careful glycemic management.
- Insulin glargine is a long-acting basal insulin analog.
- Concerns exist regarding its safety during gestation.
Purpose of the Study:
- To review literature on insulin glargine use in pregnancy.
- To assess mitogenicity, placental transfer, and maternal-fetal safety.
- To inform clinical decision-making for pregnant patients with diabetes.
Main Methods:
- Systematic literature search of MEDLINE and BIOSIS Previews.
- Inclusion of English-language studies and abstracts up to March 2011.
- Hand-searching of reference lists for additional relevant articles.
Main Results:
- 23 reports covering 1001 pregnancies were analyzed.
- Insulin glargine showed no enhanced mitogenic activity compared to native insulin.
- Transplacental transfer of insulin glargine appears negligible; no consistent adverse outcomes observed.
Conclusions:
- Insulin glargine use is justifiable for uncontrolled diabetes in pregnancy.
- Benefits of improved glycemic control are expected to exceed potential risks.
- Consider insulin glargine for patients already on it preconception.
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