Insulin four times daily is better than twice daily for diabetes in pregnancy

Diabetes mellitus complicates about 5% of all pregnancies. Good glycaemic control reduces maternal and perinatal morbidity, but there are no data on whether intensifying insulin treatment beyond the conventional twice daily regimen is of benefit. In a randomised controlled open label study in nearly 400 diabetic pregnant patients Nachum et al found that a four times daily regimen improved both perinatal outcome and maternal glycaemic control compared with the conventional twice daily regimen (p 1223). The rate of severe maternal hypoglycaemia was, however, similar in both groups.


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Relevant Article

Twice daily versus four times daily insulin dose regimens for diabetes in pregnancy: randomised controlled trial
Zohar Nachum, Izhar Ben-Shlomo, Ehud Weiner, and Eliezer Shalev
BMJ 1999 319: 1223-1227. [Abstract] [Full Text] [PDF]

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