Pharmacokinetics of Insulin Aspart in Pregnant Women With Type 1 Diabetes: Every Day Is Different

Rapid-acting insulin analogs are increasingly used during type 1 diabetic pregnancy. They may assist women to safely optimize glucose control (1,2), but little is known about their pharmacokinetics and reproducibility in pregnancy. Using a unique data set of 1,300 plasma insulin samples collected under strictly observed experimental conditions, we explored the relationship between aspart pharmacokinetics and clinical and demographic factors. We also assessed reproducibility both within and between pregnant women using continuous subcutaneous insulin infusion (CSII).In study 1 (ISRCTN62568875), 10 women were studied on two occasions under sedentary conditions with prandial boluses administered before standardized evening and breakfast meals in early (12–16 weeks) and in late (28–32 weeks) gestation (3). In study 2 (ISRCTN50385583), 12 women were studied on two occasions in midgestation (19 and 23 weeks) (4). The boluses were administered before standardized evening and breakfast meals (60-g carbohydrate dinner, 50-g carbohydrate breakfast). Physical activity was encouraged with postprandial walking (20 min after each meal) with 50 min of brisk treadmill walking (3.9 km/h) after breakfast (4). Ethics approval was obtained from Suffolk, Norfolk, and Cambridgeshire (study 1) …