Treatment of gestational diabetes with short- or long-acting insulin and neonatal outcome: a pilot study

2002 ◽  
Vol 81 (3) ◽  
pp. 258-259 ◽  
Author(s):  
Maritta Pöyhönen-Alho ◽  
Kari Teramo ◽  
Risto Kaaja
Keyword(s):  
Pilot Study ◽  
Gestational Diabetes ◽  
Neonatal Outcome ◽  
Acting Insulin ◽  
Long Acting

scholarly journals Circadian rhythm and gestational diabetes: working conditions, sleeping habits and lifestyle influence insulin dependency during pregnancy

2021 ◽  
Author(s):  
Friederike Weschenfelder ◽  
Karolin Lohse ◽  
Thomas Lehmann ◽  
Ekkehard Schleußner ◽  
Tanja Groten
Keyword(s):  
Circadian Rhythm ◽  
Gestational Diabetes ◽  
Sleep Quality ◽  
Multivariate Regression ◽  
Fasting Glucose ◽  
Work Conditions ◽  
Work Condition ◽  
Glucose Levels ◽  
Acting Insulin ◽  
Long Acting

Abstract Objective Management of gestational diabetes (GDM) is currently changing toward a more personalized approach. There  is a growing number of GDM patients requiring only a single dose of basal insulin at night to achieve glucose control. Well-known risk factors like obesity, parity and family history have been associated with GDM treatment requirements. Sleep quality and lifestyle factors interfering with the circadian rhythm are known to affect glucose metabolism. The aim of this study was to investigate the impact of such lifestyle factors on insulin requirement in GDM patients, in particular on long-acting insulin to control fasting glucose levels. Research design and methods A total of 805 patients treated for GDM between 2012 and 2016 received a study questionnaire on lifestyle conditions. Sleep quality and work condition categories were used for subgroup analysis. Independent effects on treatment approaches were evaluated using multivariate regression. Results In total, 235 (29.2%) questionnaires returned. Women reporting poor sleep conditions had higher pre-pregnancy weight and BMI, heavier newborns, more large for gestational age newborns and higher rates of hyperbilirubinemia. Treatment requirements were related to sleep and work condition categories. Multivariate regression for ‘Basal’ insulin-only treatment revealed an adjOR 3.4 (CI 1.23–9.40, p  <  0.05) for unfavorable work conditions and adjOR 4.3 (CI 1.28–14.50, p  <  0.05) for living with children. Conclusions Our findings suggest that external stressors like unfavorable work conditions and living with children are independently associated with the necessity of long-acting insulin at night in GDM patients. Thus, fasting glucose levels of pregnant women presenting with such lifestyle conditions may be subject to close monitoring.

Comparison of Hypoglycemia and Safety Outcomes With Long-Acting Insulins Versus Insulin NPH in Pregestational and Gestational Diabetes

2020 ◽  
Vol 54 (7) ◽  
pp. 669-675
Author(s):  
Allyson Sleeman ◽  
Jessica Odom ◽  
Megan Schellinger
Keyword(s):  
Gestational Diabetes ◽  
Diabetes Education ◽  
Emergency Department Visits ◽  
Published Data ◽  
Delivery Complications ◽  
Acting Insulin ◽  
Significant Difference ◽  
Safety Parameters ◽  
Glycemic Targets ◽  
Long Acting

Background: Current guidelines from the American College of Obstetricians and Gynecologists recommend insulin as the standard therapy for treatment of pregestational and gestational diabetes (PGDM and GDM). However, the guidelines do not specify which type(s) of insulin to utilize. Additionally, there are limited published data regarding safety parameters of insulin in this population. Objective: To evaluate if insulin glargine or detemir (long-acting insulin) results in less hypoglycemia, hospitalizations, or delivery complications compared with intermediate-acting insulin neutral protamine Hagedorn (NPH) in PGDM and GDM. Methods: This single-center, retrospective, observational cohort study included pregnant women who were 18 years or older with PGDM or GDM and received insulin therapy during pregnancy at an outpatient obstetric clinic. The primary outcome was the frequency of hypoglycemia (BG < 60 mg/dL). Secondary outcomes included emergency department visits and hospitalizations, delivery complications, and the duration of time at glycemic targets during pregnancy. Results: A total of 63 patients were included for evaluation. There was no significant difference in the frequency of hypoglycemia between the long-acting and NPH groups (4.4 vs 6.2 events per patient, respectively; P = 0.361). Patients receiving long-acting insulin had significantly more encounters with diabetes education (10.6 vs 5.1 visits per patient, P = 0.002) and more consistently provided glucose readings at their appointments (8.3 vs 4.8, P = 0.043). There was no difference in hospitalizations or maternal and neonatal complications. Conclusion and Relevance: Long-acting insulins did not reduce the frequency of hypoglycemia compared with NPH. The results of this study confirm the need for additional investigations with larger populations.

Novel Long-Acting Insulin Effective

2011 ◽  
Vol 6 (4) ◽  
pp. 17
Author(s):  
MIRIAM E. TUCKER
Keyword(s):  
Acting Insulin ◽  
Long Acting

Comparison of neonatal outcome in women with gestational diabetes on different pharmacoglogical agents dilevered at term

2017 ◽  
Author(s):  
Tarik Elhadd ◽  
Sindu Jacob ◽  
Vincent Boama ◽  
Khaled Ashawesh ◽  
Khaled Dukhan ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Neonatal Outcome

667 Effects of Sleep-Extend on glucose metabolism in women with a history of gestational diabetes: A pilot study

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A261-A261
Author(s):  
Sirimon Reutrakul ◽  
Pamela Martyn-Nemeth ◽  
Laurie Quinn ◽  
Kirstie Danielson ◽  
Brett Rydzon ◽  
...  
Keyword(s):  
Physical Activity ◽  
Pilot Study ◽  
Glucose Metabolism ◽  
Gestational Diabetes ◽  
Sleep Duration ◽  
Control Group ◽  
Healthy Living ◽  
Short Sleep ◽  
History Of ◽  
Sleep Extension

Abstract Introduction Experimental and epidemiological data have linked insufficient sleep to increased diabetes risk. Women with a history of gestational diabetes (GDM) have a 7-fold greater risk of developing type 2 diabetes. This pilot study explored the feasibility of a sleep extension intervention in women with a history of GDM and short sleep, and the effects on glucose metabolism. Methods Women age 18–45 years with a history of GDM (at least 1 year postpartum) and actigraphy confirmed short sleep duration (&lt;7h/night) on weekdays were randomized at a ratio of 1 control (healthy living information) to 2 cases (6 weeks of “Sleep Extend” intervention: use of a Fitbit, weekly digital content, interactive tools, and coach delivered feedback in order to increase sleep duration). An oral glucose tolerance test (OGTT), 7-day actigraphy recording and questionnaires were obtained at baseline and 6 weeks (at the end of the intervention). Results Twelve women (mean (SD) age 40.3 (4.5) years) participated (n=8 Sleep Extend, n=4 control). Compared to baseline, nightly sleep duration increased in Sleep Extend group (+30.6 (48.8) minutes) but decreased in the control group (-6.8 (22.9) minutes). Both fasting and 2-h glucose levels from OGTT increased in both groups but were greater in the control group (Sleep extend vs. healthy living: fasting glucose +2.1 (9.8) vs. +12.8 (7.3) mg/dL; 2-h glucose +8.2 (21.9) vs. +20.0 (19.4) mg/dL). Self-reported sleep quality improved in both groups. When compared controls, Sleep Extend participants reported improved fatigue symptoms (Promis fatigue score change -5.1 (9.3) vs. 7.0 (1.0), p=0.008), and self-reported physical activity tended to increase (+1614 (3659) vs. -2900 (3922) MET-minutes/week). Combining all participants, an increase in sleep duration correlated with a decrease in fatigue (r= -.62, p=0.04) and anxiety symptoms (r= -.69, p=0.02). Conclusion Sleep extension through coaching and use of remote monitoring is feasible in women with a history of GDM. It appears to decrease fatigue and may improve glucose metabolism and physical activity. Support (if any) NIDDK P30 DK092949

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