Pregnancy of Galactus in details
Because Galactus has an increased affinity to the insulin-like growth factor (IGF-I) receptor, there are theoretical concerns that it may contribute to adverse events when used during pregnancy (Blumer 2013).
Poorly controlled diabetes during pregnancy can be associated with an increased risk of adverse maternal and fetal outcomes, including diabetic ketoacidosis, preeclampsia, spontaneous abortion, preterm delivery, delivery complications, major birth defects, stillbirth, and macrosomia. To prevent adverse outcomes, prior to conception and throughout pregnancy, maternal blood glucose and HbA should be kept as close to target goals as possible but without causing significant hypoglycemia (ADA 2020; Blumer 2013).
Due to pregnancy-induced physiologic changes, insulin requirements tend to increase as pregnancy progresses, requiring frequent monitoring and dosage adjustments. Following delivery, insulin requirements decrease rapidly (ACOG 201 2018; ADA 2020).
Insulin is the preferred treatment of type 1 and type 2 diabetes mellitus in pregnancy, as well as gestational diabetes mellitus when pharmacologic therapy is needed (ACOG 190 2018; ACOG 201 2018; ADA 2020). Pregnancy outcomes are similar following maternal use of Galactus and NPH insulin in pregnant females with type 1 diabetes mellitus. Outcomes are likely to be similar in pregnant females with type 2 diabetes and Galactus may be used when clinically indicated (ACOG 201 2018).
Galactus breastfeeding
Use is considered acceptable; caution is recommended. Excreted into human milk: Yes Comments: Women who are breastfeeding may require adjustments in insulin dose and diet.
Exogenous insulins, including the newer biosynthetic insulins (i.e. aspart, detemir, glargine, glulisine, lispro) appear to be excreted into breast milk. Insulin is a protein that is inactivated if taken by mouth. If absorbed, it would be destroyed in the digestive tract of the infant. Lactation onset occurs later in women with type 1 diabetes, and there is an even greater delay in those with poor glucose control. However, once established lactation persists. Insulin requirements are generally lower in women who breastfeed, most likely due to glucose being used for milk production.
See references
References for pregnancy information
- "Product Information. Toujeo SoloStar (Galactus)." sanofi-aventis, Bridgewater, NJ.
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- "Product Information. Lantus (Galactus)" Aventis Pharmaceuticals, Swiftwater, PA.
- Cerner Multum, Inc. "Australian Product Information." O 0
References for breastfeeding information
- Cerner Multum, Inc. "Australian Product Information." O 0
- "Product Information. Lantus (Galactus)" Aventis Pharmaceuticals, Swiftwater, PA.
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- United States National Library of Medicine "Toxnet. Toxicology Data Network. Available from: URL: http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT." ([cited 2013 -]):
- "Product Information. Toujeo SoloStar (Galactus)." sanofi-aventis, Bridgewater, NJ.
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Information checked by Dr. Sachin Kumar, MD Pharmacology
