Humulin-N and pregnancy

[e||ement]

Hello everyone.
I'm recently diagnosed T1, 34 and was ttc#2 at time of diagnoses. Baby making is put on hold until given the nod by my endo (which she says shouldn't be too long because my numbers are looking good).
I'm currently doing MDI with Humulog at meals and Humulin-N at bedtime. She put me on the Humulin-N because she said it's the best during pregnancy, and doesn't want to have to switch me since I'm planning to be pregnant in the near future.
Any thoughts on Humulin-N and pregnancy?
Cheers!
Ashley

[Subby]

Sorry to haunt you here, but since you were asking in your other post I was intrigued why such a problematic basal insulin was being used. It seems the question may be around whether newer insulins than NPH (Humilin-N) are safe during pregnancy. There may be indications that there have been studies to show they are safe. Here's some previous DF posts for your reading.

http://www.diabetesforums.com/forum/diabetes/18152-lantus-safe-during-pregnancy.html

http://www.diabetesforums.com/forum/type-1-diabetes-pregnancy/28128-pregnancy-and-lantus.html

Those threads probably go into it, but the primary reason Lantus or Levemir might be preferred are that they are flatter and longer lasting, more suited to covering your background needs over 24 hours, than NPH, which also gives a bigger "peak". (I myself found NPH hugely problematic back in the day).

As to the status of the safety concerns, I leave to those much more in the know than me.

Good luck in this!

[mazea]

I was determined to go on Levemir during my pregnancy. My endocrinologist was against it, but I went on it anyway (I found a GP to give it to me) I had problems with NPH because it controlled my blood sugars erratic at best.

When making the decision to go on Levemir, I considered my blood sugar control which can also damage my baby against the risk of taking a new medication unproven to create problems/improvement in pregnancy.

Now my endo has informed me, at 10 weeks gestation and on Levemir, that about 3 babies, who's mums took Levemir during their pregnancy, have been born at her hospital and she feels ok with me being on Levemir now.

So more data of the newer insulins being safe is happening all the time.

[lilituc]

The only "better" reason I can think of is being approved for pregnancy. I don't see how NPH could possibly be better otherwise. Shouldn't the goal be to control your bg?

[e||ement]

thanks everyone ;)
i will take these comments/suggestions to my endo at my next appointment.
i appreciate your input!

[mell1682]

Ditto What everyone else said about the fluctuations on NPH. My first pregnancy I used Lantus and Humalog and the outcome was great. My daughter spent time in NICU but unrelated to diabetes control and more due to prematurity. With my second daughter, my MFM said no to Lantus due to its newness (and despite the fact that I did already have a healthy child) and she put me on NPH with Humalog. The control was a lot harder, for sure, with NPH and I had awful crashes and other problems that I never had with Lantus. Only one good thing I can say is that I could mix insulins in the same needle...but that was such a small thing and I don't mind injecting separately. That being said, my 2nd daughter came out completely healthy and spent no NICU time as I had a different set of doctors who didn't force induction so early.

[Shani]

I guess I'm the discordant voice. I was on lantus initially and got put on NPH while working up to TTC and I feel better than ever.

I did ask my endo once why I had to switch insulins (as it is, I may stay on NPH, I <3 it). Insulin interacts with many receptors involved in growth. Some of the newer insulins have not been tested when it comes to how that interaction works in pregnancy, as opposed to NPH which has been tried, tested and proven; so most OBs are more comfortable using something they KNOW is safe.

Again, erratic blood sugar may be more damaging than the possibility of receptor interaction.

good luck talking to your endo =)

[lissa5974]

In 2006 I had a beautiful 8lb. 3.5oz. baby boy while taking Humilin N and Humalog. My Endo did not feel safe using Lantus at the time. let me tell you, control is so hard, the hardest thing I have ever done, during pregnancy. However, I used the Humilin N, had an A1c of 5.3-5.8 all through pregnancy. It was fine and my son is perfectly healthy and happy to this day. No problems have been found with his heart, etc.

Melissa
Type 1--06/13/1996
OmniPod
Mother of son Rylee-2 years old

[Keezheekoni]

I've used Lantus through two pregnancies. Lantus is fine for pregnancy, most perinatologists will put you on Lantus if you're on NPH.

Lantus is perfectly safe through pregnancy and any OB worth their salt will also put you on it. They know that NPH isn't good for control, and they want your fastings under 95 and your 2 hour post-prandial under 120. There's no way NPH is going to get you there.

[JJM335]

Hi Ashley:

Like everyone says, NPH is no fun. If you are planning a pregnancy you really want to get the best possible control, which won't be helped by using N. Have you considered going onto a pump?

Joel