Evaluation of insulin antibodies and placental transfer of insulin aspart in pregnant women with type 1 diabetes mellitus

McCance, David R.; Damm, Peter; Mathiesen, Elisabeth R.; Hod, Moshe; Kaaja, Risto; Dunne, Fidelma; Jensen, L. E.; Mersebach, Henriette

doi:10.1007/s00125-008-1120-y

Cited by 48 publications

(30 citation statements)

References 11 publications

(11 reference statements)

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“…Rates of large for gestational age (LGA) and neonatal hypoglycemia were also similar. In a subset of 95 women, analysis of maternal and cord blood insulin antibody levels demonstrated low levels of insulin-specific antibodies in both insulin groups both at baseline and delivery [30]. In addition, insulin aspart was undetectable in all cord blood samples evaluated.…”

Section: Insulin Aspartmentioning

confidence: 90%

Insulin Analogues in the Management of the Pregnancy Complicated by Diabetes Mellitus

Durnwald

Landon

2010

Curr Diab Rep

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Since their introduction, insulin analogues are the preferred choice for short-acting insulin due to their superior pharmacologic profiles, leading to greater flexibility and convenience of dosing and, thus, greater patient satisfaction and improved quality of life. Over the past few years, clinical experience with insulin analogues in pregnancy has increased. The most studied, insulin lispro, has been shown to be a safe and clinically effective option in the treatment of the diabetic gravida. Studies of the other insulin analogues are limited, but promising. Further research is warranted to evaluate safety and efficacy of these analogues.

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Section: Insulin Aspartmentioning

confidence: 90%

Insulin Analogues in the Management of the Pregnancy Complicated by Diabetes Mellitus

Durnwald

Landon

2010

Curr Diab Rep

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“…These antibodies reduce the activity of fetal insulin and lead to fetal macrosomia [18,19,27]. Insulin lispro and aspart, however, do not increase these antibodies during pregnancy, and these insulin analogues have not been detected in umbilical cord blood [18,19,27]. Furthermore, several studies have suggested that these insulin analogues do not increase congenital malformations compared to RI [2,19].…”

Section: Discussionmentioning

confidence: 99%

“…It has been suggested that insulin bound to immunoglobulin antibodies can cross the placental barrier. These antibodies reduce the activity of fetal insulin and lead to fetal macrosomia [18,19,27]. Insulin lispro and aspart, however, do not increase these antibodies during pregnancy, and these insulin analogues have not been detected in umbilical cord blood [18,19,27].…”

Section: Discussionmentioning

confidence: 99%

Pregnancy and Neonatal Outcomes in Gestational Diabetes Treated with Regular Insulin or Fast-Acting Insulin Analogues

You

Choi

Roh

et al. 2015

Gynecol Obstet Invest

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Background/Aims: Fast-acting insulin analogues (FAIAs) are being used more frequently during pregnancy. Previous studies comparing regular insulin (RI) and FAIA consist primarily of women enrolled with pre-existing diabetes; therefore, we compared pregnancy and neonatal outcomes in women with gestational diabetes. Methods: We retrospectively investigated 197 pregnant women with gestational diabetes mellitus (GDM) requiring insulin treatment for glycemic control. Individuals were divided into 2 groups: RI (n = 55) and FAIA (aspart or lispro; n = 142). Pregnancy outcomes, including caesarean section rate, and neonatal outcomes, including macrosomia and ponderal index, were compared between groups. Results: There were no significant differences in maternal baseline characteristics (age, parity, body mass index and weight gain) between groups or in haemoglobinA_1c before delivery. The frequency of emergency caesarean section (caesarean section after trial of labor) was not significantly different between groups (RI 16.7%, FAIA 24.7%; p = 0.452). There were no differences in frequencies of macrosomia (RI 3.4%, FAIA 6.5%; p = 0.518), ponderal index (RI 2.65 ± 0.5, FAIA 2.71 ± 0.5; p = 0.322), cranial-thoracic circumference ratio (RI 1.07 ± 0.06, FAIA 1.07 ± 0.06; p = 0.386) or neonatal hypoglycemia (RI 5.1%, FAIA 5.8%; p = 1.000). Conclusion: Our data indicate that FAIA achieves similar pregnancy and neonatal outcomes in GDM compared with RI. Considering patient convenience, FAIA may be better to use during pregnancy.

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“…Optimal glycemic control is achieved with a combination of long-acting and rapid-acting insulin, or basal-bolus dosing, with doses administered in a way that mirrors normal physiologic insulin concentrations. The types of insulin demonstrated to be safe and effective in pregnancy are listed in Table 2 ( [41][42][43][44][45][46]. Both regular insulin and glargine are inappropriate for use during pregnancy.…”

Section: Intrapartum Management Diet and Pharmaceutical Therapymentioning

confidence: 99%

Pregnancy and Diabetes Management: Advances and Controversies

Castorino

Jovanovič

2011

Clinical Chemistry

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BACKGROUND:The treatment of diabetes in pregnancy has potentially far-reaching benefits for both pregnant women with diabetes and their children and may provide a cost-effective approach to the prevention of obesity, type 2 diabetes mellitus, and metabolic syndrome. Early and accurate diagnosis of diabetes in pregnancy is necessary for optimizing maternal and fetal outcomes.CONTENT: Optimal control of diabetes in pregnancy requires achieving normoglycemia at all stages of a woman's pregnancy, including preconception and the postpartum period. In this review we focus on new universal guidelines for the screening and diagnosis of diabetes in pregnancy, including the 75-g oral glucose tolerance test, as well as the controversy surrounding the guidelines. We review the best diagnostic and treatment strategies for the pregestational and intrapartum periods, labor and delivery, and the postpartum period, and discuss management algorithms as well as the safety and efficacy of diabetic medications for use in pregnancy.

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Evaluation of insulin antibodies and placental transfer of insulin aspart in pregnant women with type 1 diabetes mellitus

Cited by 48 publications

References 11 publications

Insulin Analogues in the Management of the Pregnancy Complicated by Diabetes Mellitus

Insulin Analogues in the Management of the Pregnancy Complicated by Diabetes Mellitus

Pregnancy and Neonatal Outcomes in Gestational Diabetes Treated with Regular Insulin or Fast-Acting Insulin Analogues

Pregnancy and Diabetes Management: Advances and Controversies

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