Guidelines from the American College of Obstetricians and Gynecologists suggest insulin for treatment of pregestational and gestational diabetes (PGDM and GDM) but don’t specify which insulin to use. Researchers have set about the task of reviewing evidence to determine if insulin glargine or detemir (long-acting insulin) results in less hypoglycemia, hospitalizations, or delivery complications compared to intermediate-acting insulin neutral protamine Hagedorn (NPH) in PGDM and GDM. . The primary outcome was the frequency of hypoglycemia (BG < 60 mg/dL). Secondary outcomes included emergency department visits and hospitalizations, delivery complications, and the duration of time at glycaemic targets during pregnancy. 63 women were evaluated, and there was no significant difference in the frequency of hypoglycemia between the long-acting and NPH groups (4.4 vs 6.2 events per patient, respectively; P = 0.361), despite the fact that those receiving long-acting insulin had significantly more encounters with diabetes education (10.6 vs 5.1 visits per patient, P = 0.002). No difference in hospitalizations or maternal and neonatal complications was detectable. The original study was recently published here.
Long-acting and NPH insulins appear to provide outcomes similar for gestational diabetes
Jan 20, 2020