Insulin Aspart Safe During Pregnancy

Use of the rapid-acting insulin analogue insulin aspart, as a component of basal-bolus therapy with NPH insulin, indicates that it is as safe and effective as regular human insulin in pregnant women with type 1 diabetes.  Lead researcher Dr. Elisabeth Mathiesen stated that, "We now feel secure in letting women continue with modern fast-acting insulin analogues during their pregnancy.”

In addition, these drugs "used during pregnancy might reduce the number of severe hypoglycemic events, fetal losses and preterm deliveries when compared to human insulin."

Dr. Mathiesen of the University of Copenhagen and colleagues conducted an open-label study of 322 women with type 1 diabetes who were pregnant or were planning pregnancy. They were randomized to insulin aspart or human insulin as meal-time insulin.

All had A1C of 8% or less at confirmation of pregnancy. Insulin doses were titrated toward predefined glucose targets and A1C below 6.5%.

The AIC target was achieved by 80% of subjects in the second and third trimester. Human insulin and aspart were comparable in this regard.

The risk of major hypoglycemia or major nocturnal hypoglycemia was considerably less with aspart (relative risk, 0.48). Nevertheless, the difference did not reach significance.

At the end of first and third trimesters, average postprandial plasma glucose increments were significantly lower with insulin aspart than human insulin, as were mean plasma glucose levels 90 minutes after breakfast. Maternal safety profiles and pregnancy outcomes were similar between treatments.

Summing up, Dr. Mathiesen pointed out that performing randomized studies in pregnant women presents an ethical dilemma, but "it might be more unethical not to try to obtain evidence for the best treatment modality during pregnancy." It is important, she said, "that the safety and efficacy of the modern insulin analogue insulin aspart has been carefully tested in pregnant women."

Diabetes Care , April 2007 ;30:771-776.

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FACT:

Germans Are Fattest People in Europe, Study Shows: But, Germans had not yet reached US levels of obesity. "Of all industrial states the US is the country with the highest proportion of obese people." A new study has found that Germany has the highest proportion of overweight people in Europe, partly due to the country’s high beer consumption. Germans are the fattest people in Europe according to an international study, but Britain and Greece have a higher proportion of clinically obese people.  The study by the International Association for the Study of Obesity found that in Germany 75.4 percent of men and 58.9 percent of women are overweight, far higher than levels in Italy and France.