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Insulin therapy in pregnancy
Aidan McElduff1, Robert G Moses
1Discipline of Medicine, Sydney University, Sydney, NSW, Australia. aidanm@med.usyd.edu.au
Summary
Insulin therapy is crucial for managing diabetes during pregnancy. While used for type 1 and type 2 diabetes, gestational diabetes mellitus (GDM) is the most common reason for insulin use in pregnant individuals.
Area of Science:
- Obstetrics
- Endocrinology
- Pharmacology
Background:
- Insulin therapy is vital for glycemic control in pregnant women with type 1 diabetes.
- It is also frequently needed for type 2 diabetes and gestational diabetes mellitus (GDM).
- GDM is the most prevalent reason for insulin use during pregnancy due to its higher incidence.
Purpose of the Study:
- To review the role and common regimens of insulin therapy in managing diabetes during pregnancy.
- To highlight the prevalence of insulin use across different types of diabetes in pregnancy.
Main Methods:
- Review of current literature and clinical practice regarding insulin use in pregnancy.
- Analysis of common insulin regimens, including basal/bolus strategies.
Main Results:
- The basal/bolus combination of long- and short-acting insulin is the most frequent regimen used.
- No specific evidence supports one regimen over another.
- Gestational diabetes mellitus accounts for the majority of insulin use in pregnancy.
Conclusions:
- Insulin therapy is indispensable for achieving optimal glycemic control in pregnant women with diabetes.
- Individualized treatment approaches are recommended.
- Therapeutic decisions should be guided by local expertise and patient-specific factors.
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