A randomised controlled, open-label trial in an unselected cohort of pregnant women with type 1 or type 2 diabetes allocated to insulin Fiasp® or insulin NovoRapid® during pregnancy and lactation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
216
Randomization to treatment with insulin Fiasp
Randomization to standard treatment with insulin Novorapid
Center for Pregnant Women with Diabetes, Rigshospitalet
Copenhagen, Denmark
Birth weight standard deviation score
Offspring birth weight (measured as standard deviation score) adjusted for gestational age and gender
Time frame: At delivery
HbA1c levels
HbA1c levels in pregnancy, one and three months after delivery
Time frame: At inclusion in early pregnancy, at 21 weeks in pregnancy, at 33 weeks in pregnancy, at 36 weeks in pregnancy, at 1 month after delivery, at 3 months after delivery
Postprandial self-monitoring of plasma glucose (SMPG) levels
Postprandial self-monitoring of plasma glucose (SMPG) levels in pregnancy
Time frame: 9 months
Preprandial self-monitoring of plasma glucose (SMPG) levels
Preprandial self-monitoring of plasma glucose (SMPG) levels in pregnancy
Time frame: 9 months
Insulin treatment and dose (IU) including insulin pump settings
Type of insulin, dose (IU) during pregnancy, around delivery and until 3 months after delivery. In women on insulin pump therapy: appropriate insulin pump dosing (IU) during pregnancy, around delivery and until 3 months after delivery.
Time frame: At inclusion in early pregnancy, at 21 weeks in pregnancy, at 33 weeks in pregnancy, at 36 weeks in pregnancy, at 1 month after delivery, at 3 months after delivery
Continuous glucose monitoring data
The amount of time during CGM use spent in the target range 3.5-7.8 mmol/l, with glucose \<3.5 mmol/L and glucose \>7.8 mmol/L at night-time (23 pm to 7 am) and over 24 h, respectively, in pregnancy and around delivery (in the morning for induction of labour or planned caesarean section). • The percentage of time during the first one-week period after delivery spent in the target range 3.9-10.0 mmol/L, with glucose \<3.9 mmol/L and glucose \>10.0 mmol/L at night-time (23 pm to 7 am) and over 24 h, respectively.
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Time frame: 9 months
Severe hypoglycemia
The incidence of severe hypoglycemia in the year preceding pregnancy, during pregnancy and the first three months after giving birth
Time frame: 2 years
Mild hypoglycaemia
The incidence of mild hypoglycemia during pregnancy and the first three months after giving birth.
Time frame: 12 months
Maternal weight
Maternal weight in pregnancy and after delivery
Time frame: At inclusion in early pregnancy, at 21 weeks in pregnancy, at 33 weeks in pregnancy, at 36 weeks in pregnancy, at 1 month after delivery, at 3 months after delivery
Pregnancy complications and outcomes
The prevalence of miscarriage, mode of delivery, early preterm delivery (before 34 completed weeks), preterm delivery (before 37 completed weeks), preeclampsia and perinatal death
Time frame: 9 months
Fetal overgrowth
The prevalence of fetal overgrowth, defined as the offspring birth weight SD score +1.28 or \>90th percentile
Time frame: At birth
Infant weight
Infant weight during the first 3 months of life
Time frame: 3 months
Neonatal morbidity (neonatal hypoglycaemia, jaundice, respiratory distress and duration of stay in neonatal intensive care unit) and infant morbidity evaluated as hospitalization during the first 3 months of life (after discharge in the neonatal period)
Neonatal morbidity
Time frame: 3 months