Diabetic pregnancy outcomes in mothers treated with basal insulin lispro protamine suspension or NPH insulin: a multicenter retrospective Italian study |
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Authors: | Maria Grazia Dalfrà Angela Soldato Paolo Moghetti Simonetta Lombardi Carmela Vinci Angela Pia De Cata |
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Institution: | 1. DPT Medicina, Università di Padova, Padova, Italy, mariagrazia.dalfra@sanita.padova.it;3. DPT Medicina, Università di Padova, Padova, Italy,;4. DPT Medicina, Università di Verona, Verona, Italy,;5. UO Diabetologia e Endocrinologia Azienda, ULSS 5 Veneto, Veneto, Italy,;6. UO Diabetologia Azienda, ULSS 10 Veneto, San Donà di Piave, Italy,;7. UO Diabetologia Azienda, ULSS13 Veneto, Dolo, Italy, |
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Abstract: | Objective: The aim of this study was to study the efficacy and safety of long-acting insulin analog insulin lispro protamine suspension (ILPS) in diabetic pregnant women.Methods: In a multicenter observational retrospective study, we evaluated pregnancy outcome in 119 women affected by type 1 diabetes and 814 with gestational diabetes (GDM) treated during pregnancy with ILPS, compared with a control group treated with neutral protamine hagedorn (NPH) insulin.Results: Among type 1 diabetic patients, fasting blood glucose at the end of pregnancy was significantly lower in ILPS-treated than in NPH-treated patients. HbA1c levels across pregnancy did not differ between groups. Caesarean section and preterm delivery rates were significantly lower in the ILPS-women. Fetal outcomes were similar in the ILPS and NPH groups. Among GDM women, fasting blood glucose at the end of pregnancy was significantly lower in ILPS-treated than in NPH-treated patients. Duration of gestation was significantly longer, caesarian section and preterm delivery rates were lower in the ILPS-treated group. In addition, there were significantly fewer babies with an excessive ponderal index or neonatal hypoglycemic episodes in the ILPS group than in the NPH group.Conclusions: Association of ILPS with rapid-acting analogs in pregnancy is safe in terms of maternal and fetal outcomes. |
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Keywords: | Diabetes insulin therapy pregnancy |
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