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Safety and efficacy of insulin detemir versus NPH in the treatment of diabetes during pregnancy: Systematic review and meta-analysis of randomized controlled trials.
Athanasiadou, Kleoniki I; Paschou, Stavroula A; Stamatopoulos, Theodosios; Papakonstantinou, Evgenia; Haidich, Anna-Bettina; Goulis, Dimitrios G.
Afiliación
  • Athanasiadou KI; 2(nd) Department of Internal Medicine and Diabetes Centre, 417 Veteran's Fund Military Hospital NIMTS, Athens, Greece. Electronic address: kleoniki.ath@gmail.com.
  • Paschou SA; Endocrine Unit and Diabetes Centre, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece.
  • Stamatopoulos T; Department of Neurosurgery, 401 General Military Hospital, Athens, Greece.
  • Papakonstantinou E; Department of Pediatric Oncology, Ippokratio General Hospital, Thessaloniki, Greece. Electronic address: eugepapa@yahoo.gr.
  • Haidich AB; Department of Hygiene, Social-Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece. Electronic address: haidich@auth.gr.
  • Goulis DG; Unit of Reproductive Endocrinology, 1(st) Department of Obstetrics and Gynaecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece. Electronic address: dgg@auth.gr.
Diabetes Res Clin Pract ; 190: 110020, 2022 Aug.
Article en En | MEDLINE | ID: mdl-35878788
AIMS: To compare the safety and efficacy of insulin detemir versus neutral protamine Hagedorn (NPH) in pregnant women with diabetes. METHODS: MEDLINE, CENTRAL, Google Scholar databases, and ClinicalTrials.gov registry were searched from inception to December 2021 to identify randomized controlled trials (RCTs) concerning adult women with singleton pregnancies, gestational or pregestational diabetes, and the need for insulin therapy. A systematic review and a meta-analysis (weighted data, random-effects model) were performed. Continuous outcomes were expressed as mean difference (MD) with 95% confidence interval (CI) (inverse variance method); dichotomous outcomes were expressed as risk ratio (RR) with 95% CI (Mantel-Haenszel method). Heterogeneity was quantified using the I2 index. RESULTS: Five RCTs involving 1450 participants met the inclusion criteria. Outcomes that showed significant results in favor of insulin detemir over NPH were maternal hypoglycemic events (RR 0.64, 95% CI 0.48-0.86, p = 0.003; I2 = 0%) and gestational age at delivery (MD 0.48, 95% CI 0.16-0.81, p = 0.003; I2 = 0%). CONCLUSIONS: Insulin detemir was associated with less maternal hypoglycemic events and decreased risk for prematurity compared with NPH insulin. More research should be conducted to reach a safe conclusion about the optimal insulin regimen for women with diabetes in pregnancy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Insulina de Acción Prolongada / Diabetes Mellitus Tipo 1 Tipo de estudio: Clinical_trials / Prognostic_studies / Systematic_reviews Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Diabetes Res Clin Pract Asunto de la revista: ENDOCRINOLOGIA Año: 2022 Tipo del documento: Article Pais de publicación: Irlanda
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Insulina de Acción Prolongada / Diabetes Mellitus Tipo 1 Tipo de estudio: Clinical_trials / Prognostic_studies / Systematic_reviews Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Diabetes Res Clin Pract Asunto de la revista: ENDOCRINOLOGIA Año: 2022 Tipo del documento: Article Pais de publicación: Irlanda