Comparison of treatment with insulin Detemir and NPH in women with gestational diabetes mellitus: glycemic control and pregnancy outcomes

Abstract Purpose. The objective of this retrospective study was to compare glycemic control, pregnancy outcome, as well as fetal/neonatal outcomes, between women with gestational diabetes mellitus (GDM) treated with (a) insulin detemir and (b) insulin neutral protamine Hagedorn (NPH). Methods. A total of 192 women with GDM were included. 98 women received detemir, while 94 women received NPH. Data regarding medical history, glycemic control, time and mode of delivery, as well as neonatal outcomes were recorded. Results. Baseline characteristics were comparable between the two groups. There were no differences with respect to the week of insulin initiation, total insulin dose, duration of insulin therapy, daily insulin dose/weight in early and late pregnancy, as well as the number of insulin injections per day. Maternal overall weight gain during pregnancy, and weight gain per week did not differ either. The detemir group had slightly lower HbA1c level at the end of gestation [median: Det 5.2% (33 mmol/mol) vs NPH 5.4% (36 mmol/mol), p = 0.035). There were no hypoglycemias or allergic reactions in both groups. There were also no differences regarding neonatal outcomes Conclusion. The use of insulin detemir for glucose control was found to be equally effective and safe compared with NPH.