Insulin Therapy for Gestational Diabetes
(START2 Trial)
Trial Summary
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications. It is best to discuss this with the trial coordinators or your healthcare provider.
What data supports the effectiveness of insulin therapy for gestational diabetes?
Research shows that insulin analogs like Humalog and insulin detemir are effective in managing blood sugar levels during pregnancy, which is crucial for reducing complications in diabetic women. Studies indicate that these insulins help achieve good metabolic control without adverse effects on mothers or babies.12345
Is insulin therapy safe for use during pregnancy and in general?
Research shows that insulin analogs like lispro, aspart, glargine, and detemir are safe during pregnancy, as they do not cross the placenta or cause harm to the mother or baby. These insulins have favorable properties that help maintain stable blood sugar levels, reducing the risk of low blood sugar episodes.678910
How does insulin therapy differ from other treatments for gestational diabetes?
Insulin therapy for gestational diabetes is unique because it involves direct administration of insulin to manage blood sugar levels, which can be more effective for those who do not respond well to diet and exercise alone. Unlike metformin, which is an oral medication, insulin can be adjusted more precisely to meet individual needs, especially in cases of high insulin resistance or allergies to specific insulin types.1112131415
What is the purpose of this trial?
The aim of our study is to compare neonatal and maternal outcomes using different thresholds for the initiation and titration of pharmacotherapy for gestational diabetes (GDM). Our goal is to compare a Strict and permissive threshold. The Strict study arm target range will be 65-120 mg/dL, with time in range goal of 70%. The permissive study arm target range will be 65-140 mg/dL, with target time in range goal of 70%.
Eligibility Criteria
This trial is for pregnant individuals diagnosed with gestational diabetes. Participants should be those who are being considered for pharmacotherapy to manage their blood sugar levels. Specific eligibility criteria are not provided, but typically participants would need to meet certain health standards and not have conditions that could interfere with the study.Inclusion Criteria
Exclusion Criteria
Timeline
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Participants are assigned to either a strict or permissive threshold for pharmacotherapy initiation and titration for gestational diabetes, monitored using continuous glucose monitoring
Follow-up
Participants are monitored for maternal and neonatal outcomes, including neonatal composite outcomes and maternal hypoglycemia
Treatment Details
Interventions
- Insulin
Insulin is already approved in European Union, United States, Canada for the following indications:
- Diabetes mellitus
- Diabetes mellitus
- Diabetes mellitus
Find a Clinic Near You
Who Is Running the Clinical Trial?
Thomas Jefferson University
Lead Sponsor
University of Rochester
Collaborator