From Durham, North Carolina, USA:
I am so confused by all of this lispro insulin in pregnancy information. I have had really great results with the lispro (Humalog) and fear switching back to Regular in order to get pregnant. I want to believe that if lispro helps me control my diabetes, then it will help me to have a healthy pregnancy. Am I living in a dream world? I'm not pregnant yet, but we plan to start trying in a month or two. If lispro isn't necessarily safe, how long should I be off it before trying to conceive?
The information about lispro and pregnancy is very limited and is based on a few case reports. Therefore, if you continue the use of Lispro in the first 8-10 weeks of pregnancy, you may be taking a small risk of some fetal abnormalities. However, I have had patients using this type of insulin throughout pregnancy without any problems.
If your diabetes is poorly controlled around the time of conception and early pregnancy, then there is clear data that the fetus is at higher risk of congenital abnormalities. So, if you can maintain good control using Regular insulin, may want to consider switching temporarily during the time of conception.
Additional comments from Dr. Quick:I am unaware of any guidelines on how long before conception to switch from lispro to Regular. My own advice to my patients is to switch a few months before, to allow plenty of time to "get used to" the Regular, and to check a glycohemoglobin whilst on the Regular to be sure it's okay for pregnancy.
I agree it's an entirely unsatisfactory situation, but with two case reports of fetal problems in women who were on lispro during pregnancy, I really am uncomfortable with recommending lispro insulin using during early pregnancy.
Last Updated: Tuesday April 06, 2010 15:08:57
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