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Insulin analogues in pregnancy

15th March 2022
pregnant female visiting doctor who is using insulin pen on her finger

We’ve come a long way in improving pregnancy outcomes for women with type 1 diabetes, but research continues and drug companies are advancing their insulin offerings. In the latest episode in our Insulin@100 series, Professor Elisabeth Mathieson outlines what we’ve discovered about insulin analogues during pregnancy in the past 20 years and and what the recent EXPECT trial set out to do.

Improving pregnancy outcomes for women with type 1 diabetes has long been the research interest of Professor Elisabeth Mathieson. “Every Monday – and I have done this for many, many years – I’m sitting in the clinic with pregnant ladies with diabetes, taking care of their diabetes, trying to improve their diabetes control and thereby improving their pregnancy outcomes.” 

As Elisabeth details at the start of her presentation, insulin has come a long way in the 100 years since it was first made available as a treatment for diabetes, including a flowering of successive generations of insulin analogues, with more innovations in the pipeline. “But we have a major question,” she says. “Are insulin analogues safe to use in pregnancy? More than 20 years ago, we questioned ourselves whether the insulin analogues would be safe. We were a little worried and therefore we decided to perform randomised controlled trials looking into this issue. And I’ve been lucky to participate in these trials.”

In this presentation, Elisabeth discusses how far we’ve come in understanding the best insulin options, covering the outcomes of various trials investigating this area, culminating in her report on results from the recent EXPECT trial, which compared the use of insulin degludec versus insulin detemir in women with type 1 diabetes who were either pregnant or planned to become so.

To hear the full results of that trial, watch Elisabeth’s complete presentation ‘Improving outcomes’ here on Horizons.

For more from Professor Mathiesen on gestational and pregestational diabetes, enrol on the following EASD e-Learning courses:

Any opinions expressed in this article are the responsibility of the EASD e-Learning Programme Director, Dr Eleanor D Kennedy.