From Adelaide, South Australia, Australia:
I'm using Humalog and NPH. I'm 17 weeks pregnant and I've been told, by a doctor at my Women's and Children's Clinic, that it's recommended by them that I change back to Regular insulin as they feel I may be at some risk using Humalog as they are not sure of what to expect (towards baby) while in womb. My sugar level overall average is 5.6. This has caused me to become stressed by this remark as my diabetic specialist advised me that there is no reason for me to change, as my sugar levels are very good. I should also tell you that I have had type 1 for 22 years, and I'm 30 years old. I've been on Humalog for four years and found that my diabetes has been more controlled. I really want to stay on Humalog but if it in any way might affect my unborn child. Can you advise me of any problems directly related to child defects from using Humalog?
I have been using Humalog during pregnancy without any problems. If you achieve better control with the Humalog, then stick with it. If there is any risk, it is primarily in the first trimester, and you are beyond that now.
Additional comments from :Jovanovic et al. published their experience with insulin lispro in the treatment of gestational diabetes in the September 1999 issue of Diabetes Care. Insulin lispro was not associated with malformations, increased formation of antibodies, and there were fewer episodes of hypoglycemia in a population of women with gestational diabetes, treated at 14-32 weeks gestation. This article does not adequately address risk of fetal malformations because therapy was initiated after organ development.
[Editor's comment: When Humalog first became available, there had been no testing of its effects during pregnancy, especially of the possibility of damage to the early development of the fetus during the first few months of pregnancy. A letter was published in the New England Journal of Medicine reporting some cases of congenital abnormalities in babies of diabetic mothers using Humalog. However, these could not be absolutely attributed to this type of insulin. I am unaware of any further reports of problems that might be due to the insulin, but many doctors have taken the viewpoint that it might be safer to use Regular insulin instead of Humalog during the first 10-12 weeks of pregnancy, when the baby's organs are developing, until further safety information is available. WWQ]
Original posting 22 Sep 2000
Posted to Family Planning
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