Insulin aspart (rDNA origin) injection (brand name, NovoLog), a rapid-acting human insulin analog, provides better control of blood glucose following meals than regular insulin in women with gestational diabetes, according to new research published this month in Diabetes Care(1).The findings are important because better control of post-meal blood glucose (postprandial glycemia) in gestational diabetes is associated with improved maternal and neonatal outcomes and with healthier birth weight.

"Because insulin aspart acts more rapidly than regular human insulin, we hypothesized it would provide better postprandial glycemic control -- which is just what we found," said lead investigator David Pettitt, from the Sansum Medical Research Institute in Santa Barbara, California."Given the link between postprandial glucose levels and pregnancy outcomes shown in other studies, these results suggest insulin aspart may improve outcomes for both mothers and infants," he said.

Gestational diabetes mellitus (GDM), diabetes that is first recognized and diagnosed during pregnancy, occurs in about seven percent of pregnancies, though prevalence rates vary with ethnicity and maternal age.Pregnant women should be assessed for risk of GDM at their first prenatal visit, and retested between the 24th and 28th week of pregnancy.

GDM is associated with an increased risk for preeclampsia, Cesarean delivery, congenital abnormalities, perinatal mortality, maternal hypertension and diabetes, and obesity and diabetes in the offspring. The most common neonatal complication of GDM is abnormally large body size (macrosomia), which occurs in as many as 40 percent of cases.Neonatal macrosomia, in turn, is associated with increased risk of developing obesity in childhood and adulthood. GDM is treated through diet but may require insulin therapy to maintain adequate control of blood glucose levels. Oral hypoglycemic agents, used to treat type 2 diabetes, are generally not used to treat GDM because they can be toxic to the fetus.