A Study in Patient Outcomes: The Application of an Insulin Analogue in Pregnancy

2.50
Hdl Handle:
http://hdl.handle.net/10755/154808
Type:
Presentation
Title:
A Study in Patient Outcomes: The Application of an Insulin Analogue in Pregnancy
Abstract:
A Study in Patient Outcomes: The Application of an Insulin Analogue in Pregnancy
Conference Sponsor:Sigma Theta Tau International
Conference Year:2004
Conference Date:July 22-24, 2004
Author:Hothersall, Loretta, MSN, RNC, CS, FNP-C
P.I. Institution Name:Maine Center for Endocrinology and Diabetes
Title:Family Nurse Practitioner
Introduction: Glargine insulin has not been approved for use during pregnancy and is considered a Pregnancy Category C. Despite the lack of safety data,clinical determination to continue the use of this insulin was necessary to eliminate recurrent hypoglycemia and the repeated need for glucagon injections with resultant elevations in serum ketone levels and deleterious maternal and fetal outcomes. Objective:To decrease the frequency and severity of hypoglycemic events. To have no greater rate of neonatal complications. Design: Quantitative. Sample: A sample of convenience,(~14)women whose pregnancies were complicated by type 1 or type 2 diabetes and followed at a Diabetes Center in Scarborough, Maine. Methods: Women were divided into 2 groups: (Group 1) women who were well controlled on Glargine prior to conception and wished to remain on this regimen during pregnancy. (Group2) women who were converted from a conventional regimen of insulin to Glargine due to frequent episodes of hypoglycemia and or control issues.During antepartum, maternal and fetal testing was carried out according to protocol as well as maternal glycemic control based on HbA1c,complications and BMI. Maternal delivery and neonatal evaluations were gathered postpartum via chart reviews. Analysis: Analysis of variance was applied to test for differences between the groups in the following outcome variables: glycemic control, frequency of hypoglycemia, and fetal outcomes. Conclusion: Due to the limitations of this study, further study is needed to define the efficacy and safety of Glargine use during pregnancy. The use of Glargine eliminated nocturnal hypoglycemia secondary to stringent glycemic target ranges and decreased the rate of poor neonatal outcomes. Implications: The result of this study will promote a stratergy for the treatment of women with diabetes while improving the quality of patient care.
Repository Posting Date:
26-Oct-2011
Date of Publication:
22-Jul-2004
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleA Study in Patient Outcomes: The Application of an Insulin Analogue in Pregnancyen_GB
dc.identifier.urihttp://hdl.handle.net/10755/154808-
dc.description.abstract<table><tr><td colspan="2" class="item-title">A Study in Patient Outcomes: The Application of an Insulin Analogue in Pregnancy</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2004</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">July 22-24, 2004</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Hothersall, Loretta, MSN, RNC, CS, FNP-C</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Maine Center for Endocrinology and Diabetes</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Family Nurse Practitioner</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">lorettahothersal@aol.com</td></tr><tr><td colspan="2" class="item-abstract">Introduction: Glargine insulin has not been approved for use during pregnancy and is considered a Pregnancy Category C. Despite the lack of safety data,clinical determination to continue the use of this insulin was necessary to eliminate recurrent hypoglycemia and the repeated need for glucagon injections with resultant elevations in serum ketone levels and deleterious maternal and fetal outcomes. Objective:To decrease the frequency and severity of hypoglycemic events. To have no greater rate of neonatal complications. Design: Quantitative. Sample: A sample of convenience,(~14)women whose pregnancies were complicated by type 1 or type 2 diabetes and followed at a Diabetes Center in Scarborough, Maine. Methods: Women were divided into 2 groups: (Group 1) women who were well controlled on Glargine prior to conception and wished to remain on this regimen during pregnancy. (Group2) women who were converted from a conventional regimen of insulin to Glargine due to frequent episodes of hypoglycemia and or control issues.During antepartum, maternal and fetal testing was carried out according to protocol as well as maternal glycemic control based on HbA1c,complications and BMI. Maternal delivery and neonatal evaluations were gathered postpartum via chart reviews. Analysis: Analysis of variance was applied to test for differences between the groups in the following outcome variables: glycemic control, frequency of hypoglycemia, and fetal outcomes. Conclusion: Due to the limitations of this study, further study is needed to define the efficacy and safety of Glargine use during pregnancy. The use of Glargine eliminated nocturnal hypoglycemia secondary to stringent glycemic target ranges and decreased the rate of poor neonatal outcomes. Implications: The result of this study will promote a stratergy for the treatment of women with diabetes while improving the quality of patient care.</td></tr></table>en_GB
dc.date.available2011-10-26T13:17:43Z-
dc.date.issued2004-07-22en_GB
dc.date.accessioned2011-10-26T13:17:43Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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