insulin in pregnancy - nini2020

[ArchivalUser]

is Glargine safe in pregnancy?

[ArchivalUser]

YES,, if disease is not controlled by diet therapy alone ,, you can use glargine before using insulin because it donot cross placenta

[ArchivalUser]

Insulin glargine:- less well-studied, and given its long pharmacologic effect, may exacerbate periods of maternal hypoglycemia.

Insulins lispro, aspart, regular and NPH are well-studied in pregnancy and regarded as safe and efficacious

[ArchivalUser]

UW or kaplan says glargine is c/i in pregnancy & during lactation. i did google search & they says it is safe during both period.

what is the significance of using glargine before using insulin? Glargine is a type of insulin prepn only advantage is 24 hr action so pt has to use once a day

[ArchivalUser]

well it is written in CK new book that u can use glargine in pregnancy

[ArchivalUser]

Insulins lispro, aspart, regular and NPH are well-studied in pregnancy and regarded as safe and efficacious. Insulin glargine is less well-studied, and given its long pharmacologic effect, may exacerbate periods of maternal hypoglycemia.

http://emedicine.medscape.com/article/127547-treatment

For gest DM--NPH is the most common insulin that ob's prescribe here.. I was on NPH for my Gest DM.

[ArchivalUser]

Human insulin is the least immunogenic of the commercially available preparations. The three rapid acting insulin analogs (lispro, aspart, glulisine) are comparable in immunogenicity to human Regular insulin, but only lispro and aspart have been investigated in pregnancy and shown to have acceptable safety profiles, minimal transfer across the placenta, and no evidence of teratogenesis. Neonatal outcomes are similar to those of women treated with regular insulin [30]. These two insulin analogs both improve postprandial excursions compared to human Regular insulin and are associated with lower risk of delayed postprandial hypoglycemia.

Long-acting insulin analogs (insulin glargine, insulin detemir) have not been studied extensively in pregnancy, however, a multinational trial on the safety and efficacy of insulin detemir for the treatment of type 1 diabetic women is almost complete. Based on available data, we prefer use of human NPH insulin as part of a multiple injection regimen in pregnant women [54]. There are good data supporting the safety and effectiveness of NPH in pregnancy and doses can be adjusted frequently and quickly in response to changing requirements in pregnant women.


So, NPH is preferred and Lispro Aspart can be used.

[ArchivalUser]

thanks to all. I did a q yesterday where they gave both choices NPH & glargine. I selected NPH & the correct answer was glargine... I was confused.... anyway thanks to all of u.