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Re: [IP] Humalog and Pregnancy (was RE: insulins)




The Association for Birth Defect Children may also have information about this
also. They have a wed site but I don't have thier address for it-sorry.
Ginny




At 11:42 AM 4/5/99 , you wrote:
>Tara (and everyone else),
>
>I did the research a while ago and am trying to piece together my sources
>again.  My Endo confirmed my understanding, and I was able to re-find the
>following on the web.  While some of this info is a little dated, I was
>looking into this in about September 1998.  I am unaware of any updates and
>would welcome any new info.  I would like to try lispro.  I am listing the
>document name when applicable, the address, and the snippet that applies.  I
>think #4 is the most technical one, and the one upon which all others seem
>to be based.  You can read Lilly Research's response in this item as well.
>
>1) ADA January 1999 Clinical Practice Recommendations, S87 Continuous
>Subcutaneous Insulin Infusion
><http://www.diabetes.org/DiabetesCare/Supplement199/S87.htm>http://www.dia
betes.org/DiabetesCare/Supplement199/S87.htm
>Insulin for pumps
>The rapid-acting insulin analog lispro is an appropriate insulin for insulin
>infusion pumps. The stability of this insulin in both MiniMed and Disetronic
>pumps has been confirmed. Two controlled trials demonstrated improved
>postprandial glucose control with rapid-acting insulin as compared to
>short-acting insulin (regular) when delivered immediately before a meal by
>CSII. Lispro is not approved for use in pregnancy.
>
>2)Diabetes Monitor - Planning a Pregnancy
><http://www.diabetesmonitor.com/planpreg.htm>http://www.diabetesmonitor.co
m/planpreg.htm
>If you are presently taking Humalog insulin: we are presently not
>recommending using lispro insulin, either in a pump or by injection, when
>planning pregnancy. There are no studies indicating whether Humalog is safe
>during early pregnancy, and there are two reported cases of women on lispro
>insulin who had pregnancies with problems despite excellent glycohemoglobin
>values. (Whether these problems were due to the lispro, or to other causes,
>was undetermined.) Rearranging the insulin program, going back to Regular
>after getting used to lispro, is clearly a problem for most patients. I
>stress to my patients the importance of making the switch before conception
>when possible. 
>
>3)
><http://www.childrenwithdiabetes.com/d_0j_100.htm>http://www.childrenwithd
iabetes.com/d_0j_100.htm
>On October 2, 1997, The New England Journal of Medicine published a letter
>to the editor about possible adverse fetal effect of insulin lispro and a
>reply by a spokesperson for Lilly Research Laboratories. This letter was
>based upon two pregnancies with problems, neither of which can be clearly
>ascribed to lispro insulin [HumalogŪ brand]. We publish this hyperlink
>because it is important for our readers to know that there are cases of
>diabetic women with excellent glycohemoglobin values who may have problems
>with their pregnancies. Whether these problems are due to the lispro, or to
>other causes, is unknown. (We have also answered a question from a reader
>about this problem.) 
>
>4)The New England Journal of Medicine -- October 2, 1997 -- Vol. 337, No. 14
>
>Possible Adverse Fetal Effect of Insulin Lispro
><http://www.nejm.org/content/1997/0337/0014/1009.asp>http://www.nejm.org/c
ontent/1997/0337/0014/1009.asp
><snip>
>The report of the two infants with congenital abnormalities raises the
>possibility that insulin lispro has embryotoxic actions. We cannot rule out
>other potential causes of the abnormalities in these babies, (2) but we do
>not believe that suboptimal glycemic control contributed to the poor fetal
>outcome. 
><snip>
>
>
>Ellen Compell (Age 30)
>Type II, Pumping since Dec. 1998
>MiniMed 507C
>email @ redacted <<mailto:email @ redacted>mailto:email @ redacted> 
>
>-----Original Message-----
>From: Tara Dufour
[<mailto:email @ redacted%5D>mailto:email @ redacted]
>Sent: Monday, April 05, 1999 10:34 AM
>To: email @ redacted
>Subject: RE: [IP] insulins
>
>
>Do you mind if I askwhere you got your sources from?  I am prenant and into
>my second trimester and have been using Humalog for 2 years now and have
>never heard of anything regarding birth defects. I am confident that my
>doctor would have informed me of this when I first told him I was pregnant
>if this were the case.
>
>>Velosulin is what I use.  It is basically buffered R.  It is also the only
>>insulin that women either pregnant or planning pregnancy should use because
>>of unexplained birth defects when some women used Humalog.
>>
>>Thanks,
>>
>>Ellen Compell (Age 30)
>>Type II, Pumping since Dec. 1998
>>MiniMed 507C
>>email @ redacted <<mailto:email @ redacted>mailto:email @ redacted>
>>
>>
>>-----Original Message-----
>>From: Tara Dufour
[<mailto:email @ redacted%5D>mailto:email @ redacted]
>>Sent: Monday, April 05, 1999 8:47 AM
>>To: email @ redacted
>>Subject: Re: [IP] insulins
>>
>>
>>What is Velosulin? I've never heard of it. Does it work the same as Humalog
>>as far as action and peak times?
>>
>>>Yes, Humalog fits pump useage very well. Some people find that the Humalog
>>>doesn't
>>>work well for more than about 2.5 days, so it's recommended that you mix R
>>or
>>>Velosulin with it in a 5 to 1 ratio to keep it stable for longer periods.
>>>Seems to work well for most.
>>>
>>>Ted Quick
>>>email @ redacted
>>>----------------------------------------------------------
>>>Insulin Pumpers website
<http://www.insulin-pumpers.org/>http://www.insulin-pumpers.org/
>>>for mail subscription assistance, contact: HELP@insulin-pumpers.org
>>
>>
>>Tara Dufour
>>Hargreaves, Charbonneau & Associates
>>
>>
>>----------------------------------------------------------
>>Insulin Pumpers website
<http://www.insulin-pumpers.org/>http://www.insulin-pumpers.org/
>>for mail subscription assistance, contact: HELP@insulin-pumpers.org
>>----------------------------------------------------------
>>Insulin Pumpers website
<http://www.insulin-pumpers.org/>http://www.insulin-pumpers.org/
>>for mail subscription assistance, contact: HELP@insulin-pumpers.org
>
>
>Tara Dufour
>Hargreaves, Charbonneau & Associates
>
>
>----------------------------------------------------------
>Insulin Pumpers website
<http://www.insulin-pumpers.org/>http://www.insulin-pumpers.org/
>for mail subscription assistance, contact: HELP@insulin-pumpers.org
>----------------------------------------------------------
>Insulin Pumpers website
<http://www.insulin-pumpers.org/>http://www.insulin-pumpers.org/
>for mail subscription assistance, contact: HELP@insulin-pumpers.org
> 

----------------------------------------------------------
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for mail subscription assistance, contact: HELP@insulin-pumpers.org