Insulin Degludec in the Management of Hyperglycemia in Pregnancy: Real-World Evidence on Glycemic Control and Outcomes
Rutul Gokalani, Piyush Desai, Manoj Chawla, Dipak Chudasama, Subhajyoti Ghosh, Abhishek Srivastava, Vrunda Bhatt, Deepak Kumar Das, Aswin Mukundan, Munjal Pandya, Banshi SabooAbstract
Introduction:
Insulin degludec is an ultra-long-acting basal insulin characterized by low day-to-day variability compared to first-generation basal insulins. While its pharmacological advantages are well established in type 1 and type 2 diabetes, real-world data on its use in hyperglycemia in pregnancy (HIP) remain limited. This study aimed to evaluate maternal glycemic control, insulin requirements, and pregnancy outcomes in HIP treated with insulin degludec under real-world clinical conditions.
Materials and Methods:
This retrospective observational study included 97 pregnant women with HIP. Participants received basal–bolus insulin, with insulin degludec as the basal component and faster-acting insulin aspart (Fiasp) as the most frequently used bolus insulin (taken thrice a day). Data on demographics, glycemic parameters, and maternal and neonatal outcomes were extracted from medical records and analyzed using appropriate statistical methods.
Results:
The mean maternal age was 32.5 ± 4.47 years, and body mass index was 30.6 ± 5.98 kg/m
2
. Hemoglobin A1c significantly decreased from 7.58% at baseline to 6.30% at delivery (
Conclusion:
Insulin degludec was associated with effective glycemic control, low hypoglycemia rates, and favorable maternal and neonatal outcomes in HIP. Supported by EXPECT trial data and endorsed by national and international clinical recommendations, degludec emerges as a viable basal insulin option in pregnancy.