Delhi: Treatment with insulin detemir versus other basal insulins in pregnant women with preexisting diabetes is associated with a similar risk of major congenital malformations and neonatal mortality, show results from a recent prospective study. The study findings appear in the journal Diabetes Care.
Elisabeth R. Mathiesen, Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark, and colleagues aimed to compare the risk of severe adverse pregnancy complications in women with preexisting diabetes.
For this purpose, they conducted a multinational, prospective cohort study to assess the prevalence of newborns free from major congenital malformations or perinatal or neonatal death (primary endpoint) after treatment with insulin detemir (detemir) versus other basal insulins.
The study included a total of 1,457 women, out of which 727 received detemir and 730 received other basal insulins.
Upon analysis, the researchers found the following:
The prevalence of newborns free from major congenital malformations or perinatal or neonatal death was similar between detemir (97.0%) and other basal insulins (95.5%) (crude risk difference 0.015; adjusted risk difference −0.003).
The crude prevalence of one or more congenital malformations (major plus minor) was 9.4% vs. 12.6%, with a similar risk difference before (−0.032) and after (−0.036) adjustment for confounders.
Crude data showed lower maternal HbA1c during the first trimester (6.5% vs. 6.7% [48 vs. 50 mmol/mol]) and the second trimester (6.1% vs. 6.3% [43 vs. 45 mmol/mol]) and a lower prevalence of major hypoglycemia (6.0% vs. 9.0%), preeclampsia (6.4% vs. 10.0%), and stillbirth (0.4% vs. 1.8%) with detemir compared with other basal insulins. However, differences were not significant post adjustment.
The findings showed that insulin detemir was associated with a similar risk to other basal insulins of major congenital malformations, perinatal or neonatal death, hypoglycemia, preeclampsia, and stillbirth, concluded the authors.
Reference:
The study titled, "Risk of Major Congenital Malformations or Perinatal or Neonatal Death With Insulin Detemir Versus Other Basal Insulins in Pregnant Women With Preexisting Diabetes: The Real-World EVOLVE Study," is published in the journal Diabetes Care.
DOI: https://care.diabetesjournals.org/content/early/2021/07/30/dc21-0472