Patients with Diabetes Mellitus Managed with Insulin Detemir: Hospital Outcomes [18E]

INTRODUCTION: Approximately 7% of pregnancies are complicated by diabetes mellitus. Due to a greater prevalence of obesity and sedentary lifestyle, the prevalence of diabetes is increasing globally. The aim of this study is to evaluate hospital outcomes of patients with diabetes mellitus managed with insulin detemir during pregnancy. METHODS: We retrospectively reviewed all patients managed with insulin detemir at a single maternal fetal medicine clinic. Patients included in the study delivered between January 1, 2007 and August 31, 2016 at a single institution. Patients were excluded if pregnant with a neonate not expected to survive, or if hospital stay was beyond 21 days. IRB committee approval was obtained for this study. RESULTS: Of 161 patients, 154 were included in the final analysis. The majority of patients had gestational diabetes (75.3%, n=116) and were white (73.4%, 113/150). Average maternal age at delivery was 31.0±5.4 years old (range: 19-43). Sixty-six were obese at the initial appointment (42.9%). Average hospital stay was 2.6±1.2 days (range: 1-8). Half of patients delivered via cesarean (51.3%, n=79). Average neonatal weight was 3.3±0.6 kilograms (range: 1.3-5.0). APGAR scores were 8 at 1 minute (54.4%, 74/136), and 9 at 5 minutes (78.5%, 117/136). Average neonatal glucose was 62.3±14.0 mg/dL (range: 37-107). Average maternal glucose during the hospital stay was 109.2±22.6 mg/dL (range: 67.3-184). Six (3.9%) patients received regular insulin treatment during their hospital stay. CONCLUSION: Among patients treated with insulin detemir during pregnancy, few patients required supplemental insulin treatment during the hospital stay for delivery. Neonatal outcomes were satisfactory.