Diabet Med. 2003 Jan;20(1):46-50.
Pregnancy outcome in Type 1 diabetes mellitus
treated with insulin lispro (Humalog).
Masson EA, Patmore JE, Brash PD, Baxter M, Caldwell
G, Gallen IW, Price PA, Vice PA, Walker JD, Lindow
SW.
Diabetes Centre, The Michael White Center for
Diabetes and Endocrinology, Hull Royal Infirmary,
Hull, UK.
Aims:
The use of insulin lispro in pregnancy has not
been systematically investigated despite its
increasing use. Pooled data from seven centres with
experience in the use of insulin lispro were
accumulated to evaluate pregnancy outcome in women
with Type 1 diabetes.
Methods:
Seven units with
specialist obstetric diabetes services were
recruited to describe their total experience with
insulin lispro in pregnancy. Outcomes with respect
to the rate of miscarriage, congenital abnormality,
perinatal mortality and maternal parameters were
recorded in a standardized format.
Results:
Outcomes
on 71 babies from 76 pregnancies were documented.
There were six (7.8%) early miscarriages. All 71
babies were liveborn with a mean gestational age of
37.2 weeks, and median birthweight of 3230 g. Seven
babies weighed > 4 kg. There were four congenital
abnormalities (5.6%). There was a 72% increase in
the mean insulin dose (0.75-1.29 IU/kg per day).
Maternal glycaemic control improved throughout
pregnancy. No women developed retinopathy de novo
during pregnancy and six with established
retinopathy required laser therapy during pregnancy.
Conclusions:
The use of insulin lispro in Type 1
diabetes during pregnancy results in outcomes
comparable to other large studies of diabetic
pregnancy.