Endocrine Abstracts

Glargine is an analogue insulin which has a peakless action profile over approximately 24 hours. As a result it has been shown to reduce the frequency of hypoglycaemia thereby enabling achievement of tight glycaemic control. This is important during pregnancy in order to lower the risk of foetal malformations.

Method: 17 women, mean age 28 years, with type 1 Diabetes Mellitus on a basal bolus regimen including Glargine became pregnant between January 2004 and January 2005. Two women were switched back to conventional insulins when pregnancy was confirmed due to concerns about safety with Glargine but the remainder continued with Glargine throughout gestation.

Results: There were 3 early miscarriages in women who had poor glycaemic control at conception with a mean HbA1c of 9.6%. In the remaining pregnancies the mean HbA1c at conception was 8%. Glycaemic control improved significantly during gestation and the mean HbA1c dropped to 7.3% (6–8%). One woman developed hypertension but the rest of the pregnancies were uncomplicated. All women were delivered at term, 2 vaginally and 12 by Caesarean section. There was 1 baby born with an absent forearm but no other congenital abnormalities.

Conclusion: By improving glycaemic control Glargine may help to reduce the risk of diabetes-related complications in pregnancy. However, further data are necessary regarding its safety before it is used routinely in pregnancy.