Does lispro improve blood glucose control and birth weight

Abstract Objective: We compared the impact of Lispro insulin on Hb A 1C and birth weight (BW) with the impact of standard insulin. Study design: Patients with pregestational or gestational diabetes who needed insulin before 20 weeks in pregnancy were evaluated. Patients with iatrogenic preterm delivery were excluded. Demographic and clinical data were collected, including Hb A 1C from each trimester and BW percentiles (BW%). The Hb A 1C levels and BW% of Lispro (Group 1) and standard insulin (Group 2) were compared using the Mann-Whitney U test for continuous variables and Fisher’s exact test for categorical variables. Results: Fifty patients were evaluated (Group 1 = 21, Group 2 = 29). There were no significant differences in demographics. Group 1 Group 2 P Hb A 1C 1st trimester 8.04 ± 1.74 9.24 ± 2.14 NS Hb A 1C 2nd trimester 7.28 ± 1.74 7.57 ± 1.44 NS Hb A 1C 3rd trimester 6.95 ± 1.51 7.5 ± 1.27 NS GA (weeks) 36.7 ± 1.4 36.7 ± 1.6 NS BW >90% 1/21 (4.8%) 6/29 (20.7%) 0.051 C/S 13/21 (61.9%) 17/29 (58.6%) NS Conclusions: Lispro does not appear to improve blood glucose control as represented by Hb A 1C levels. There is a trend toward less macrosomia with Lispro. Further study is needed to determine whether Lispro improves perinatal outcomes.