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February 15, 2000

Family Planning, Insulin Analogs

Question from Somerset, New Jersey, USA:

I am a 26 year old Type 1 diabetic and I was diagnosed 6 years ago. I am currently using an insulin pump with Humalog. I am planning to get pregnant in the near future. What do you consider to be a good A1c number -- prepregnancy? My last was 6.6 -- Should I wait until it is 6.0? Also, I was seeing an endocrinologist who didn't fear any problems using Humalog. I know that you have been asked this question a few times, but what is the latest and greatest information about using Humalog during pregnancy?

Answer:

If you can get your hemoglobin A1c into the normal range for your laboratory, that will be fine. I am not aware of any new information regarding Humalog in pregnancy other than the letter from the New England Journal that I have referred to in the past.

OWJ

[Editor’s comment: A recent study (Metabolic and immunologic effects of insulin lispro in gestational diabetes by Lois Jovanovic, et al, Diabetes Care 1999 Sep;22(9):1422-7) concludes that Humalog is safe in pregnancy for women with gestational diabetes.

JSH]