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Glucose Targets and Insulin Choice in Pregnancy: What Has Changed in the Last Decade?

  • Diabetes and Pregnancy (M-F Hivert and CE Powe, Section Editors)
  • Published:
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Abstract

Purpose of Review

To review current glycaemic targets and the potential use of newer insulin formulations in pregnancy.

Recent Findings

The impact of stricter glycaemic control on perinatal outcomes remains controversial, showing conflicting results. Current ongoing randomised trials investigating the role of tighter glucose targets in pregnancy should help clarify the benefit of tighter glucose control. Optimal timing for self-monitoring blood glucose (SMBG) remains debatable. Data suggest that post-prandial SMBG, particularly at 1 h, offers the best prediction of adverse perinatal outcome. To achieve these targets, insulin is the standard therapy. Novel insulin formulations offer benefits outside of pregnancy. Recent data on the use of new insulins in pregnancy (e.g. insulin degludec and glargine (U 300)) is limited to case reports.

Summary

Glycaemic targets have remained unchanged in the last decade. Studies using stricter glycaemic targets may improve perinatal outcomes. Newer insulin formulations may offer increased flexibility and glycaemic control. Clinicians caring for women with diabetes striving to minimise adverse perinatal outcomes will find this review of interest.

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Papers of particular interest, published recently, have been highlighted as: • Of importance

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  1. Mount Sinai Hospital, 60 Murray St, #5027, Toronto, Ontario, M5T 3L9, Canada

    Siobhán Bacon & Denice S. Feig

  2. Department of Medicine, University of Toronto, Toronto, Canada

    Siobhán Bacon & Denice S. Feig

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Siobhán Bacon and Denice S. Feig declare that they have no conflict of interest.

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Bacon, S., Feig, D.S. Glucose Targets and Insulin Choice in Pregnancy: What Has Changed in the Last Decade?. Curr Diab Rep 18, 77 (2018). https://doi.org/10.1007/s11892-018-1054-9

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