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- Title
Maternal Glucose Control and Perinatal Outcomes of Pregnancy with Impaired Glucose Tolerance in Using Rapid Acting Insulin Analogue Insulin Aspart.
- Authors
Sugiyama, Takashi; Murabayashi, Nao; Umekawa, Takashi; Nagao, Kenji; Kamimoto, Yuki; Sugihara, Taku; Sagawa, Norimasa
- Abstract
To confirm safety and efficacy of rapid acting insulin analogue in treatment of diabetic patients with pregnancy, retrospective analyses on maternal blood glucose control and perinatal outcome of Japanese women with abnormal glucose metabolism were made in our center. In 17 women (8 with GDM, 4 with type 1 diabetes, 5 with type 2 diabetes), soluble human insulin (R) was replaced with rapid acting insulin analogue insulin aspart (IAsp) or IAsp was used to initiate insulin therapy. IAsp was initiated before pregnancy in 5 patients, during pregnancy in 9 patients, and during puerperal period in 3 patients. We evaluated change of blood glucose control with HbA[sub 1c] as the indicator. Perinatal outcomes of IAsp (n=14) were evaluated by comparing with control group in which patients treated with soluble human insulin at the same period (n=15). The QOL of patients was evaluated by DTSQ and our original questionnaire (n=13). Mean HbA[sub 1c] significantly improved from 6.6±1.1% with R (just before starting to use IAsp) to 5.9±0.7% in 2 months after the start (p=0.019). There was no significant difference in insulin dose. Frequency of hypoglycemia was trended to decline. As for perinatal outcomes, there were no significant differences in PIH, malformation, naonatal hypoglycemia and hyperbilirubinemia between two groups. Mean gestational age was 38.0 weeks in R group and 37.6 weeks in IAsp group. Mean birth weight was 3,138±196 g with R group and 3,078±932 g in IAsp group. Deterioration of diabetic retinopathy was not found in any patients. Total scores of DTSQ were higher with IAsp group than R group. All respondents showed their preference to IAsp because of improved control, reduced hypoglycemia, no need for divided diet, and convenience of injection immediately before meal. In conclusion, IAsp is considered to be as safe as R, and to improve HbA[sub 1c] in Japanese patients with diabetes in pregnancy. The result also indicated that insulin aspart could contribute patients' QOL enhancement.
- Subjects
JAPAN; BLOOD sugar; GESTATIONAL diabetes; INSULIN; TREATMENT of diabetes; QUALITY of life
- Publication
Diabetes, 2007, Vol 56, pA703
- ISSN
0012-1797
- Publication type
Article