Sameer Ansar, Saadia Mian, Steven Roth, George Matthew Hebdon, Saleh Aldasouqi and Ved V Gossain
Aim: Although insulin glargine is frequently being used in pregnancy, it is not approved by the FDA as the data on its safety is limited. The aim of this study was to determine the effects of insulin glargine use in pregnancy on maternal and fetal outcomes.
Methods: From the perinatal center at Sparrow Hospital, Lansing, Michigan the charts of 92 women with diabetes (gestational diabetes, type 1 diabetes and type 2 diabetes) who were treated with insulin glargine during pregnancy were reviewed. Maternal and fetal outcomes were recorded.
Results: Eighteen women had continued pre-pregnancy insulin glargine use through pregnancy and 74 were started on insulin glargine during pregnancy. The average HbA1c was 7.7%, 7.1% and 6.3% respectively in 1st, 2nd, and 3rd trimester. 31% of the woman had hypoglycemic episodes. No maternal deaths were reported. One pregnancy resulted in intrauterine fetal death. The rate of cesarean sections was 45% and the average age of gestation at delivery was 36 weeks. 12% of the newborns had macrosomia (defined as birth weight >4000 pounds), 2% had shoulder dystocia, and 7% had neonatal hypoglycemia. The data were compared to the outcome from prior studies of pregnant patients in NPH and insulin glargine.
Conclusion: We present data on maternal and perinatal outcomes with use of insulin glargine during pregnancy at our institution. Our data compares favorably with the outcome from other studies of pregnant patients using NPH insulin.