Metabolic and immunologic effects of insulin lispro in gestational diabetes.

Abstract

Insulin lispro may be considered a treatment option for women with gestational diabetes.

Diabetes-Related Autoantibodies and Gestational Diabetes

“…Our group has reported that 44% of women receiving human insulin therapy for GDM develop IAs, which may persist up to 24 months after delivery (42). Similar findings have been described after treatment with lispro (43). GADAs and IA-2As.…”

Systematic Literature Review of Basal Bolus Insulin Analogue Therapy during Pregnancy

“…The group treated with lispro experienced fewer pre-breakfast hypoglycemic events (<55 mg/dL), but not before lunch or dinner. Mean birth weight, frequency of macrosomia, intrauterine growth restriction (IUGR), and fetal abnormalities did not significantly differ [20].…”

“…The studies observed postprandial glycemia consistently decreased, particularly 1-hour postprandially [12,20,27,31]. Of the studies that measured fasting glycemia, there were no differences between lispro and regular insulin [12,20,27,31].…”

“…Lispro has the potential to pass via the placenta if it forms immune complexes with immunoglobulins. However, Jovanovic et al [20] have shown no placental transfer via umbilical blood samples following intravenous administration of lispro during labor and similarly, Holcberg et al [60] conducted an in vitro perfusion study that demonstrated no lispro in the umbilical cord [20,58,59]. …”

“…Jovanovic et al [20] randomized 42 women diagnosed with GDM between 14 and 32 weeks' of gestation, who were insulin naïve, to lispro (19 women) and regular insulin (23 women). A test meal consisting of 20% of daily caloric need was given before breakfast and followed by subcutaneous injection of the calculated initial daily insulin of either lispro or regular insulin.…”