AIM: The best way to treat pregnant patients who have type 1 diabetes is still unclear. For this reason, the present study compared metabolic control and maternal-fetal outcomes in patients treated with continuous subcutaneous infusions of rapid-acting insulin analogues (CSII) or with insulin glargine and multiple daily injections of rapid-acting insulin analogues (glargine-MDI). METHODS: This retrospective multicentre study involved 144 women with type 1 diabetes, 100 of whom were using CSII and 44 glargine-MDI. Outcomes analyzed were metabolic control, diabetes complications, pregnancy outcome, perinatal morbidity and mortality, and fetal malformations. RESULTS: The two groups were comparable for age, prepregnancy BMI, primiparous rate and diabetes complications, although patients using CSII had longer duration of diabetes (P=0.03) and higher White classifications (P=0.04). In both groups, metabolic control improved during pregnancy, but good control was reached earlier among patients using CSII. At parturition, patients using CSII had lower HbA(1c) (6.2±0.7% vs 6.5±0.8%; P=0.02) and required less insulin (P<0.01). Weight gain was similar in both groups, and maternal-fetal outcomes did not differ. CONCLUSION: In pregnant patients with type 1 diabetes, MDI and CSII are equivalent in terms of metabolic control and fetal-maternal outcomes, although patients using CSII achieved good control earlier and with less insulin.
AIM: The best way to treat pregnant patients who have type 1 diabetes is still unclear. For this reason, the present study compared metabolic control and maternal-fetal outcomes in patients treated with continuous subcutaneous infusions of rapid-acting insulin analogues (CSII) or with insulin glargine and multiple daily injections of rapid-acting insulin analogues (glargine-MDI). METHODS: This retrospective multicentre study involved 144 women with type 1 diabetes, 100 of whom were using CSII and 44 glargine-MDI. Outcomes analyzed were metabolic control, diabetes complications, pregnancy outcome, perinatal morbidity and mortality, and fetal malformations. RESULTS: The two groups were comparable for age, prepregnancy BMI, primiparous rate and diabetes complications, although patients using CSII had longer duration of diabetes (P=0.03) and higher White classifications (P=0.04). In both groups, metabolic control improved during pregnancy, but good control was reached earlier among patients using CSII. At parturition, patients using CSII had lower HbA(1c) (6.2±0.7% vs 6.5±0.8%; P=0.02) and required less insulin (P<0.01). Weight gain was similar in both groups, and maternal-fetal outcomes did not differ. CONCLUSION: In pregnant patients with type 1 diabetes, MDI and CSII are equivalent in terms of metabolic control and fetal-maternal outcomes, although patients using CSII achieved good control earlier and with less insulin.
Authors: Padmini D Ranasinghe; Nisa M Maruthur; Wanda K Nicholson; Hsin-Chieh Yeh; Todd Brown; Yong Suh; Lisa M Wilson; Elisabeth B Nannes; Zack Berger; Eric B Bass; Sherita Hill Golden Journal: J Womens Health (Larchmt) Date: 2015-02-25 Impact factor: 2.681
Authors: Melissa M Kallas-Koeman; Jason M Kong; Jennifer A Klinke; Sonia Butalia; Abhay K Lodha; Ken I Lim; Qiuli M Duan; Lois E Donovan Journal: Diabetologia Date: 2014-01-17 Impact factor: 10.122
Authors: Guillermo E Guzmán Gómez; Julian A Viggiano; A Silva-De Las Salas; Veline Martínez; María A Urbano Bonilla Journal: Case Rep Endocrinol Date: 2021-09-21
Authors: Carol J Levy; Nicole C Foster; Stephanie N DuBose; Shivani Agarwal; Sarah K Lyons; Anne L Peters; Gabriel I Uwaifo; Linda A DiMeglio; Jennifer L Sherr; Sarit Polsky Journal: J Diabetes Sci Technol Date: 2020-11-20