What are your thoughts on Lantus during pregnancy? I had the talk with my endo last week about pregnancy and she informed me that I would need to be on NPH during pregnancy. There are no clinical studies on the effects of Lantus on the baby. I was on NPH in the dark ages and it was horrible in comparison. I am not ready to get pregnant at this point because of my A1C, but thinking towards the future. I am really overwhelmed by the required numbers and my ability to reach them. I have had type 1 for 21 years and have never had an A1C of 6. I fear that NPH will make these numbers even harder to obtain and maintain. I am terrified of all the complications that go along with pregnancy. At age 31, I am feeling pretty devastated at the thought that we will not be able to have a baby.

Hi Karin! I am in pre-conception stages as well, and my vote is for NPH during pregnancy. My endo switched me from Lantus to NPH last year. Maybe it was because I’ve only ever been on Lantus (only diabetic since 2003), but I didn’t find the switch to be that difficult. I was able to bring my A1C down from 7.5 to 6.5 in about 3 months and am now at 5.7 less than a year later. I also wore a CGM from the endo for a few days soon after the switch to find out my problem times of the day. I’ve found that really tight carb counting is what has helped me continue to lower the A1C. It is a really boring existence because I eat basically the same thing every day, but it is worth it. I don’t think NPH makes it harder.

I have no pregnancy experience (yet!), but have you considered trying a pump of some sort? Even just for before and during pregnancy? I have been able to get down to the low 6’s only now that I use the Omnipod… I was just thinking that this way you would only have to use regular insulin, not switch to NPH (I am shocked that they still use it!) Anyway, best of luck!!

Hi Karin! Have you decided what you will do yet?

I have also heard that you should not use Lantus during pregnancy.

I think that MANY women preparing for pregnancy have their first A1c around 6 when preparing for pregnancy (at least among the people that I know!!!). I think that you should do the best you can to get close to 6. Perhaps try it with NPH. And if you see that it is not working, then you could try the pump. (I’m assuming that you prefer injections).

If you are open to trying the pump, I think that it can be a great tool during pregnancy, especially when combined with a CGMS!

Keep us posted on how you are doing!

My advice: get a second opinion. There are no detailed studies of lantus and how it will affect the baby - true. But there is no specific reason to think that it would. Also, the MOST important thing is your control, which you’re right, would probably be worse on NPH. I remember those days, that insulin was so much worse than lantus. This is my experience, I’m sure other people disagree with me.

On a pump you would use fast acting insulin only, so this particular concern goes away.

I was 6.3 for months before trying to conceive and during pregnancy I have been 6.3. Everything is going very well so far - had detailed u/s and fetal echo a few weeks ago and everything is norma.l. I’d like to be a bit lower, but I am doing my best.

There is a good type I diabetes / pregnancy yahoo group called positivediabeticpregnancies. Check it out! I learn a lot there.

Did your endo maybe mention switching to Levemir?

Levemir is also insulin analogue (just as Humalog, Novorapid, Apidra and Lantus are), it’s long-acting with no peaks, although it has a shorter action compared to Lantus. Therefore, many people take it twice a day.