Studies are needed to support optimal insulin dose titration in gestational diabetes mellitus: A systematic review

Isabelle K Mayne; Henry M Tyzack-Clark; Andrew P McGovern

doi:10.1016/j.dsx.2023.102746

Studies are needed to support optimal insulin dose titration in gestational diabetes mellitus: A systematic review

Diabetes Metab Syndr. 2023 Apr;17(4):102746. doi: 10.1016/j.dsx.2023.102746. Epub 2023 Mar 21.

Authors

Isabelle K Mayne¹, Henry M Tyzack-Clark², Andrew P McGovern³

Affiliations

¹ University of Exeter Medical School, Exeter, UK. Electronic address: isabelle.mayne@nhs.net.
² Torbay and South Devon NHS Foundation Trust, Torquay, UK.
³ University of Exeter Medical School, Exeter, UK; University Hospitals Plymouth NHS Trust, Plymouth, UK.

PMID: 36966543
DOI: 10.1016/j.dsx.2023.102746

Abstract

Background and aims: We aimed to summarise the existing literature on insulin dose titration in gestation diabetes.

Methods: Databases: Medline, EMBASE, CENTRAL and CINAHL were systematically searched for trials and observational studies comparing insulin titration strategies in gestational diabetes.

Results: No trials comparing insulin dose titration strategies were identified. Only one small (n = 111) observational study was included. In this study, patient-led daily basal insulin titration was associated with higher insulin doses, tighter glycaemic control, and lower birthweight, vs weekly clinician-led titration.

Conclusions: There is a paucity of evidence to support optimal insulin titration in gestational diabetes. Randomized trials are required.

Keywords: GDM; Gestational diabetes mellitus; Insulin titration.

Publication types

Systematic Review

MeSH terms

Birth Weight
Diabetes Mellitus, Type 2*
Diabetes, Gestational* / drug therapy
Female
Humans
Hypoglycemic Agents / therapeutic use
Insulin / therapeutic use
Observational Studies as Topic
Pregnancy
Pregnancy in Diabetics*

Substances

Insulin
Hypoglycemic Agents