The Use of Insulin Glargine With Gestational Diabetes Mellitus

We agree with the recent letter by Woolderink et al. (1) that insulin glargine use during pregnancy may be appropriate. In contrast to that letter, which described the use of insulin glargine in pregnant women with type 1 diabetes, we detail the use of insulin glargine in four patients with gestational diabetes mellitus (GDM). Target blood glucose levels set by the American College of Obstetricians and Gynecologists for women with GDM include fasting glucose ≤95 mg/dl and 1-h postprandial glucose ≤130–140 mg/dl or 2-h postprandial glucose ≤120 mg/dl (2). These criteria are used by the Maternal-Fetal Medicine Clinic at Wake Forest University School of Medicine to determine the need for insulin. …