Conference Proceedings - School of Nursing & Midwifery - Trinity ...

School of Nursing & Midwifery, Trinity College Dublin: 8 th Annual Interdisciplinary Research Conference
Transforming Healthcare Through Research, Education & Technology: 7 th – 9 th November 2007
Conference Proceedings
The study design was quantitative research applying ANNOVA. The
setting was a Diabetes Center, in southern Maine. The sample
consisted of 51 women (with either pre-existing type 1 diabetes or
type 2 diabetes).Women was informed at their first office
appointment of the FDA status regarding Glargine insulin in
pregnancy. They were offered the option of staying on the analog or
switching to a conventional therapy using NPH insulin. Notations
were made in the charts recording the woman’s understanding of
both therapies. Data were collected from clinical visits and hospital
records.
Women in both groups were equally educated in SMBG and target
ranges, meal planning (carbohydrate counting), exercise regimens
(unless restricted by their OB provider) and stress reduction. They
were expected to keep logs for glucose levels and food diaries.
The study findings concluded that HbA1c values for women on
Glargine insulin equaled 6.42% while the women on conventional
therapy (NPH) equaled 7.15%. Hypoglycemic events defined by a
finger stick of less then 60mg/dl, was noted at 29% for the Glargine
insulin group versus 30% for the conventional therapy (NPH). The
causes for hypoglycemia were similar in both groups ( over
compensation for elevated values, miscalculation of carbohydrates,
and hyperemesis). Perinatal complications included fewer SAB, lack
of retinal changes and PTL in the Glargine insulin group. PIH was
similar in both groups. In the Glragine group, 89% delivered at
term gestation with less NICU interaction while in the conventional
group 50% delivered at term with longer NICU stays.
The findings of this limited case study concluded that women on the
Glargine regimen had as good as, if not better glycemic control than
the conventional therapy (NPH). Hypoglycemic episodes were
similar however none needing EMT assistance in the Glargine insulin
group. Perinatal complications were less regarding retinopathy and
pre-term delivery and there were fewer incidences of neonatal
complications in the Glargine insulin group.
It is therefore recommended, that ongoing clinical trials are needed
to define the efficacy and safety of Glargine insulin in pregnancy as
well as the continued assessment of the offspring of these women
for developmental issues during the first 5 years of life.
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