Insulin analog use and pregnancy outcomes among women with Gestational Diabetes Mellitus (GDM): A retrospective analysis at the University of Santo Tomas Hospital

ABSTRACT

Introduction@#Approximately 40% of women with gestational diabetes mellitus (GDM) will require insulin when diet failed to reduce glycemic levels. Insulin analogs have been noted to result in an improved glycemic control and an acceptable safety profile in diabetes mellitus. Our general objective was to evaluate the efficacy, safety, and pregnancy outcomes of insulin analog versus human insulin in women with GDM.@*Methods@#Retrospective cohort analysis of women with singleton pregnancy and GDM from January 2013 to March 2016 at the University of Santo Tomas Hospital was performed. Women were grouped into Group A (diet-controlled), Group B (supplementary insulin analog), Group C (supplementary human insulin), and Group D (combination of supplementary insulin analog and human insulin). Maternal characteristics, glycemic data, and outcomes and neonatal outcomes were compared among the treatment groups. Parametric data were expressed as mean, standard deviation, frequency, and percentage. Chi-square and one-way analysis of variance were utilized to analyze data.@*Results@#Of 144 women with GDM, 59 received insulin analog and 19 received human insulin. Good glycemic control and low rate of hypoglycemia in Group B were comparable to other groups. Maternal outcomes (hypertensive disorders of pregnancy and primary cesarean section) in Group B were not increased and similar to other groups. Neonatal outcomes (birth weight, large for gestational age, neonatal hypoglycemia, neonatal jaundice, and acute respiratory distress syndrome) in Group B were also not increased and comparable to other groups. Rates of prematurity were higher in Groups A and B.@*Conclusion@#Our study demonstrated that insulin analog was comparable to human insulin in terms of non-increased rates of adverse pregnancy outcomes with the exception of prematurity, and can be safely used as a viable treatment option without increased risk of hypoglycemia while achieving optimal glycemic control throughout pregnancy in Filipino women with GDM.