Abstract
Summary Background: Pregnancy related adverse outcomes are worse in women with diabetes than in non-diabetic women. In addition, different new types of insulin and regimens have been developed. However; the optimal insulin therapy strategies in pregnant women with preexisting diabetes are currently indistinct. Aim of study : The purpose of this study is to compare the effectiveness and fetal outcome of four different insulin regimens in pregnant women with preexisting diabetes. Material and Methods : This study was longitudinal study, it was carried out in diabetic pregnancy unit (DPU), Aljalaa Maternity Hospital during 2017. The study population comprised pregnant women with preexisting diabetes mellitus who fulfilled eligibility criteria. The questionnaire has the following sections: personal data, parity, types of diabetes mellitus, insulin regimen, gestational hypertension, preeclampsia , basic and last glycolated hemoglobin, hypoglycemia, gestational age at the time of delivery, mode of delivery and indication, birth weight, fetal congenital abnormality, birth trauma, five minute Apgar score, admission to nursery and perinatal death . Results: Analyzing the data indicated that all regimens under study are effective in controlling blood sugar. In view of maternal and fetal outcome, Insulin analogues regimen especially Aspart and Glargine was associated with the lowest incidence adverse outcome. Conclusion : All insulin regimens under study are effective in controlling blood sugar during pregnancy, and although there are no statistically significant difference regarding maternal and fetal outcome, insulin analogues revealed less incidence of adverse outcome compared with conventional insulin. Recommendations : ● Use of insulin analogues for pregnant women with pre-existing diabetes on wide range to improve maternal and fetal outcomes. ● More clinical trials are warranted to provide evidence on long term safety