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Cochrane Reviews Insulin Use in Pregnant Women
Cochrane Database Syst Rev; 2017 Feb 3; O’Neill, et al
Sufficient evidence is lacking to identify differences between the various insulin types and regimens for pregnant women with pre-existing type 1 or 2 diabetes, according to a recent Cochrane review.
Investigators looked at 5 randomized trials involving 554 women and babies. Among the results:
- There were no differences between rapid-acting human insulin and regular insulin for pre-eclampsia, abnormalities in the baby, or the need for a caesarean.
- A comparison of human and animal insulin did not show a difference in the number of babies with macrosomia.
- There were no differences between pre-and self-mixed insulin groups in the number of babies with macrosomia, or the number of women who had a caesarean section.
- In a comparison of insulin injected with a pen and a needle, women using the pen were less likely to have a caesarean section, although the number of macrosomic babies was not different.
- A comparison of long-acting insulin Detemir and intermediate-acting neutral protamine Hagedorn insulin found no difference in the number of fetal abnormalities.
Citation:
O’Neill S, Kenny L, Khashan A, West H, Smyth R, Kearney P. What is the best insulin type and regimen for pregnant women with pre-existing diabetes? Cochrane Database Syst Rev. 2017 Feb 3;2:CD011880. doi:10.1002/14651858.CD011880.pub2.