Possible fetal outcome of insulin aspart
Yükleniyor...
Dosyalar
Tarih
2008
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Italian Society of Endocrinology (SIE)
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
The issue of whether insulin aspart and other analogues
cross the human placenta is debated. We report a 31-yrold Type 2 diabetic multiparous woman who used insulin
aspart at conception and during the first 6 weeks of pregnancy and had a baby with multiple congenital anomalies.
She had excellent glucose control [glycated hemoglobulin
(HbA1c) <5.6] with oral anti-diabetic agents when she came
to our clinic and was considering becoming pregnant. Since
she did not accept multiple injections, split dose insulin
treatment was initiated [30% regular, 70% human isophane
(NPH) insulin]. The patient’s blood glucose was regulated
quite well during this treatment. However, the treatment
was switched to analogue insulin at the same dosage (70%
insulin aspart protamine suspension and 30% insulin aspart
injection, Novo Nordisk formulation) by another doctor. At
the next visit, she was 6-week pregnant; the analogue insulin was stopped and multiple injections were initiated (as
mealtime regular and bedtime NPH) and this therapy was
maintained until birth. No other drugs were used throughout the pregnancy. There was no consanguinity between
parents. In the rest of the pregnancy, an optimal glucose
regulation was provided (maximum fasting glucose <88
mg/dl, maximum post-prandial glucose <138 mg/dl, maximum HbA1c<6.1). She had a cesarean section at 29th gestational week and delivered a newborn with multiple congenital malformations including ambiguous genitalia due
to 5-α reductase enzyme deficiency, anomalous course of
left coronary artery, hemi-vertebra and horseshoe kidney.
Theoretically, there could be at least 3 reasons explaining the fetal malformations in this baby: pre-gestational
diabetes, maternal age, and insulin aspart that was used
during the first 6 weeks of the pregnancy.
Açıklama
Anahtar Kelimeler
Insulin Aspart
Kaynak
Journal Of Endocrinological Investigation
WoS Q Değeri
Q4
Scopus Q Değeri
Q2
Cilt
31
Sayı
9
