Treatment with the long-acting insulin analog degludec during pregnancy in women with type 1 diabetes: An observational study of 22 cases

TY - JOUR

T1 - Treatment with the long-acting insulin analog degludec during pregnancy in women with type 1 diabetes

T2 - An observational study of 22 cases

AU - Keller, Maria Fredsgaard

AU - Vestgaard, Marianne

AU - Damm, Peter

AU - Mathiesen, Elisabeth Reinhardt

AU - Ringholm, Lene

PY - 2019

Y1 - 2019

N2 - Aim: To report glycemic control and pregnancy outcome in pregnant women with type 1 diabetes on insulin degludec. Methods: Twenty-two women with type 1 diabetes on degludec from conception to delivery between 2014 and 2018 were compared with 51 pregnant women with type 1 diabetes on glargine. Results: Baseline characteristics were comparable, however HbA1c was higher at median 9 (range 5–19) weeks in women on degludec compared to women on glargine (6.9% (5.7–8.7); (52 (39–72) mmol/mol) versus 6.4% (5.1–10.1); (46 (32–87) mmol/mol), p = 0.04). HbA1c was similar in late pregnancy (6.3% (5.6–7.1); (45 (38–54) mmol/mol) versus 6.1% (5.2–9.0); (43 (33–75) mmol/mol), p = 0.28). The prevalence of severe hypoglycemia was 3 (14%) versus 6 (12%), p = 1.00 during pregnancy and 0 versus 1, p = 1.00 during hospital admittance after delivery. Most women on degludec used one daily injection in early (20 (91%) versus 25 (49%), p = 0.001) and late pregnancy (21 (96%) versus 19 (37%), p < 0.001). No significant differences in obstetrical and neonatal outcomes were found between the groups. Maternal hospital admittance after delivery was 2 (1–5) versus 3 (2–11) days (p = 0.004). Conclusions: Glycemic control in late pregnancy, severe hypoglycemia during and immediately after pregnancy as well as pregnancy outcome were comparable in women on degludec or glargine. Degludec initiated preconceptionally may be continued in pregnancy.

AB - Aim: To report glycemic control and pregnancy outcome in pregnant women with type 1 diabetes on insulin degludec. Methods: Twenty-two women with type 1 diabetes on degludec from conception to delivery between 2014 and 2018 were compared with 51 pregnant women with type 1 diabetes on glargine. Results: Baseline characteristics were comparable, however HbA1c was higher at median 9 (range 5–19) weeks in women on degludec compared to women on glargine (6.9% (5.7–8.7); (52 (39–72) mmol/mol) versus 6.4% (5.1–10.1); (46 (32–87) mmol/mol), p = 0.04). HbA1c was similar in late pregnancy (6.3% (5.6–7.1); (45 (38–54) mmol/mol) versus 6.1% (5.2–9.0); (43 (33–75) mmol/mol), p = 0.28). The prevalence of severe hypoglycemia was 3 (14%) versus 6 (12%), p = 1.00 during pregnancy and 0 versus 1, p = 1.00 during hospital admittance after delivery. Most women on degludec used one daily injection in early (20 (91%) versus 25 (49%), p = 0.001) and late pregnancy (21 (96%) versus 19 (37%), p < 0.001). No significant differences in obstetrical and neonatal outcomes were found between the groups. Maternal hospital admittance after delivery was 2 (1–5) versus 3 (2–11) days (p = 0.004). Conclusions: Glycemic control in late pregnancy, severe hypoglycemia during and immediately after pregnancy as well as pregnancy outcome were comparable in women on degludec or glargine. Degludec initiated preconceptionally may be continued in pregnancy.

KW - Degludec

KW - Glycemic control

KW - Hypoglycemia

KW - Pregnancy outcome

KW - Type 1 diabetes

U2 - 10.1016/j.diabres.2019.05.004

DO - 10.1016/j.diabres.2019.05.004

M3 - Journal article

C2 - 31102682

AN - SCOPUS:85065793115

SN - 0168-8227

VL - 152

SP - 58

EP - 64

JO - Diabetes Research and Clinical Practice

JF - Diabetes Research and Clinical Practice

ER -