Gestational Diabetes Mellitus: Insulinic Management

Review Article

DOI: 10.1007/s13224-014-0525-4

Cite this article as:
Magon, N. & Seshiah, V. J Obstet Gynecol India (2014) 64: 82. doi:10.1007/s13224-014-0525-4

Abstract

Diabetic pregnancies have attendant risks. Adverse fetal, neonatal, and maternal outcomes in a diabetic pregnancy can be avoided by optimum glycemic control. Most pregnancies with GDM can be managed with non-insulinic management, which includes medical nutrition therapy. However, many necessitate concomitant insulinic management. The new insulin analogs present undoubted advantages in reducing the risk of hypoglycemia, mainly during the night, and in promoting a more physiologic glycemic profile in pregnant women with diabetes. Rapid-acting insulin analogs seem to be safe and efficient in reducing postprandial glucose levels more proficiently than regular human insulin, with less hypoglycemia. The long-acting insulin analogs do not have a pronounced peak effect as NPH insulin, and cause less hypoglycemia, mainly during the night. The review focuses on glycemic goals in pregnancy, insulinic management of GDM, and posology of insulin and its analogs. Clear understanding of the insulinic management of GDM is essential for women’s health care providers to provide comprehensive care to women whose pregnancies are complicated with diabetes and rechristen the ‘‘diabetic capital of the world’’ to the ‘‘diabetic care capital of the world.’’

Keywords

GDM Insulin Pregnancy Aspart Lispro Detemir Diabetes 

Copyright information

© Federation of Obstetric & Gynecological Societies of India 2014

Authors and Affiliations

  1. 1.Head, Department of Obstetrics & GynecologyAir Force HospitalJorhatIndia
  2. 2.Dr. V. Seshiah Diabetes Research Institute & Dr. Balaji Diabetes Care CentreChennaiIndia

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