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Articles by A. Lapolla
Total Records ( 3 ) for A. Lapolla
  G. Di Cianni , E. Torlone , C. Lencioni , M. Bonomo , A. Di Benedetto , A. Napoli , E. Vitacolonna , D. Manninoss and A. Lapolla

Aims  Insulin glargine (IG), with its non-peaking action profile, might be useful in diabetic pregnancy. However, data on its safety are limited and its use during pregnancy is not recommended. This study focused on the effects of IG on perinatal outcome, particularly to estimate the rate of congenital anomalies and birthweight.

Methods  This retrospective study included women with pre-gestational diabetes who used IG before (at least 1 month) and during pregnancy. For all women we recorded data regarding maternal glycaemic control and pregnancy outcome. We also compared women treated with IG throughout pregnancy and women who stopped taking IG at an earlier stage.

Results  From 27 centres, 107 Type 1 diabetic pregnancies were identified. IG was started 10.3 ± 6.9 months before conception and in 57.4% of cases was stopped during the first trimester; 42.6% of women continued using it until the end of pregnancy. There were six abortions (four spontaneous and two induced) and five newborns (4.9%) with congenital anomalies. Glycaemic control, birthweight and the prevalence of macrosomia and neonatal morbidity were similar in women who used IG for the full term compared with those who stopped IG earlier during pregnancy.

Conclusions  This study, although limited, suggests that IG is safe and effective; the rate of congenital malformations was within the range expected for diabetic pregnancies treated with more traditional forms of insulin. IG used throughout pregnancy did not seem to influence birthweight or increase adverse outcomes.

  A. Lapolla , M. G. Dalfra , E. Ragazzi , A. P. De Cata and D. Fedele
  Aims  The International Association of the Diabetes and Pregnancy Study Groups (IADPSG) Consensus Panel recommends new criteria for diagnosing gestational diabetes. We evaluated the clinical and metabolic characteristics, and pregnancy outcome, in women previously classifiable as ‘normal’ according to the 4th International Workshop Conference on gestational diabetes criteria, but reclassified as ‘abnormal’ according to the new recommendations. Methods  Using the new IADPSG criteria, 3953 pregnancies were retrospectively reclassified as 1815 women with normal glucose tolerance and 2138 with gestational diabetes, 112 (2.8%) of whom would have been classified as normal according to the older criteria. Results  Of the 2138 women classified as abnormal by the new criteria, the 112 women now reclassified as abnormal were younger and had a lower pre-pregnancy BMI than the 2026 women who had also been classified as abnormal by the previous criteria. The 100-g oral glucose tolerance test showed significantly higher glucose levels in these 112 women than in the 1815 women reclassified as normal (< 0.0001). Caesarean section was significantly more frequent (< 0.01) and the ponderal index for the newborn significantly higher in these reclassified women than in those classified as normal (< 0.0001), and their basal glucose levels correlated significantly with the ponderal index (< 0.05). Conclusion  The new criteria for diagnosing gestational diabetes identified a group of women previously classifiable as normal according to the 4th International Workshop Conference criteria, but revealing metabolic characteristics and pregnancy outcomes resembling those of women who would have been considered to have gestational diabetes by the previous criteria.
  A. Lapolla , G. Di Cianni , D. Bruttomesso , M. G. Dalfra , R. Fresa , G. Mello , A. Napoli , T. Romanelli , L. Sciacca , G. Stefanelli , E. Torlone and D. Mannino
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