[Georgia]

Does anyone know if Lantus has been approved for pregnancy?

I started taking Lantus today & am hoping that in a few months or so my consultant will give us the go ahead to try for a baby - but someone has now told me that as Lantus stays in your system for a long time it can cause extreme lows after giving birth. Anyone know if this is true?

Georgia

[Tokyo Cate]

Sorry if this contains too much science jargon. This is taken from the Lantus site. I looked at a few other sites for other insulins and most indicate pregnancy under the contraindications because, naturally, the risks extend to mother and babe and they are trying to cover themselves. The sites I looked at stressed good control prior to conception, careful monitoring during pregnancy and frequent consultation with doctors.

It looks like you should use the tool that helps you achieve the best control and you will have the best result.

I hope your new insulins work for you and you get the go-ahead soon!!

Pregnancy. The effect of pregnancy on the pharmacokinetics and pharmacodynamics of LANTUS has not been studied.

Pregnancy: Teratogenic Effects: Pregnancy Category C. Subcutaneous reproduction and teratology studies have been performed with insulin glargine and regular human insulin in rats and Himalayan rabbits. The drug was given to female rats before mating, during mating, and throughout pregnancy at doses up to 0.36 mg/kg/day, which is approximately 7 times the recommended human subcutaneous starting dose of 10 IU (0.008 mg/kg/day), based on mg/m2. In rabbits, doses of 0.072 mg/kg/day, which is approximately 2 times the recommended human subcutaneous starting dose of 10 IU (0.008 mg/kg/day), based on mg/m2, were administered during organogenesis. The effects of insulin glargine did not generally differ from those observed with regular human insulin in rats or rabbits. However, in rabbits, five fetuses from two litters of the high-dose group exhibited dilation of the cerebral ventricles. Fertility and early embryonic development appeared normal.

There are no well-controlled clinical studies of the use of insulin glargine in pregnant women. It is essential for patients with diabetes or a history of gestational diabetes to maintain good metabolic control before conception and throughout pregnancy. Insulin requirements may decrease during the first trimester, generally increase during the second and third trimesters, and rapidly decline after delivery. Careful monitoring of glucose control is essential in such patients. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.

[Georgia]

Thanks for the info & best wishes, Tokyo Cate

[Ailsa]

Sorry I don't know the answer. I was using protophane when I was pregnant.
However (& you may be aware of this already?) Insulin requirements increase throughout pregnancy. For me from day 1. By the end I was using about 3 times my normal dose. As soon as you give birth your requirement returns to normal (virtually instantaneously) & of course the newborn produces their own, so I can see a possible problem for both parties if the insulin kept working for some time.
I think you should get a professional opinion on this.
The above comments only apply to the actual time of delivery, so you could probably continue using Lantus up until a few days beforehand.
It is not uncommon for babies of T1s to be a bit on the low side for the first few days anyway, so I can see you wouldn't want to compound that problem.

[Georgia]

Originally Posted by Ailsa

Sorry I don't know the answer. I was using protophane when I was pregnant.
However (& you may be aware of this already?) Insulin requirements increase throughout pregnancy. For me from day 1. By the end I was using about 3 times my normal dose. As soon as you give birth your requirement returns to normal (virtually instantaneously) & of course the newborn produces their own, so I can see a possible problem for both parties if the insulin kept working for some time.
I think you should get a professional opinion on this.
The above comments only apply to the actual time of delivery, so you could probably continue using Lantus up until a few days beforehand.
It is not uncommon for babies of T1s to be a bit on the low side for the first few days anyway, so I can see you wouldn't want to compound that problem.

My Consultant wanted to put me on Levemir but the diabetic nurse disagreed with him & advised Lantus & mentioned it is better for pregnancy. But then afterwards I read that Lantus can remain in your system for a long while & cause extreme lows after the birth, which is concerning. I have read about insulin requirements throughout pregnancy - I intend to discuss this at my next appt. Thanks

[Lea]

My children are 10 and 7 and I was on NPH and R during my pregnancies. Having just switched to Lantus, I imagine that would make a pregnancy much easier.

After delivery, I did have some extreme lows and my insulin requirements dropped dramatically. But this was not due to the type of insulin I was on; insulin requirements in all diabetics drop dramatically after delivery. My children had a few low blood sugars as well, but I was able to take my son home 24 hours after his birth and I took my daughter home about 36 hours after birth.

When I saw my doctor this week he did mention to me that he has been using Lantus for the past year in some of his pregnant diabetic patients with great results.

Diabetic pregnancies are absolutely doable. Wishing you all the best.

[Georgia]

Thanks for the reassuring words, having only just switched to Lantus I am spending time finding out the ins & outs about it. My consultant wanted to put me on Levemir but the diabetic nurse said Lantus is better for pregnancy so hopefully all will be ok. Thanks also for the best wishes

[am1977]

Best of luck with everything... hopefully, we'll be hearing some good news from you soon

[Georgia]

Originally Posted by am1977

Best of luck with everything... hopefully, we'll be hearing some good news from you soon

Aw thanks very much & yes I hope so too