Pregnancy and insulin

The long-acting insulin, glargine, appears to be as safe in pregnancy as the intermediate-acting NPH insulin, according to a meta-analysis of eight studies of 702 women with pre-gestational or gestational diabetes. 

Of those women, 331 were treated with glargine, while 371 took NPH insulin. The study found no statistically significant differences in the occurrence of adverse fetal outcomes in either group.

No difference in the incidence of large infants in women taking glargine was detected, a fact the authors said was important due to glargine’s “increased affinity for the insulin-like growth factor receptor” which had fuelled concerns that glargine could affect fetal growth.

That does not seem to have occurred. The authors cited two limitations: all the studies were observational, and seven of the eight were retrospective.

Ann Pharmacother 2011; 45(1):1-8