OBJECTIVE: We hypothesized that bolus and basal insulin doses in women with type 1 diabetes mellitus who use insulin pumps would increase 2-fold to maintain hemoglobin A1c <6.5% across gestation. STUDY DESIGN: This was a retrospective study of 9 women with type 1 diabetes mellitus with preconceptional hemoglobin A1c ≤ 7.4% using insulin pumps. The primary outcome was absolute and percentage change of basal and bolus insulin from preconception to delivery. RESULTS: Total daily dose of insulin increased from 33.3 ± 7.8 U/d before conception to 93.5 ± 27.9 U/d at delivery. Basal rates rose modestly (50% increase, from 16.2 ± 6.5 U/d to 24.0 ± 9 U/d); bolus insulin doses quadrupled from 17.1 ± 6.1 U/d to 69.5 ± 29.6 U/d (P = .0001). Bolus insulin increased from approximately 50% of total daily dose of insulin before conception to 75% of total daily dose of insulin at 36 weeks' gestation. CONCLUSION: In well-controlled type 1 diabetes mellitus, insulin requirements increased 3-fold from before conception to 36 weeks' gestation. Most of this requirement was attributed to an increase in bolus rates that are required for control with meals.
OBJECTIVE: We hypothesized that bolus and basal insulin doses in women with type 1 diabetes mellitus who use insulin pumps would increase 2-fold to maintain hemoglobin A1c <6.5% across gestation. STUDY DESIGN: This was a retrospective study of 9 women with type 1 diabetes mellitus with preconceptional hemoglobin A1c ≤ 7.4% using insulin pumps. The primary outcome was absolute and percentage change of basal and bolus insulin from preconception to delivery. RESULTS: Total daily dose of insulin increased from 33.3 ± 7.8 U/d before conception to 93.5 ± 27.9 U/d at delivery. Basal rates rose modestly (50% increase, from 16.2 ± 6.5 U/d to 24.0 ± 9 U/d); bolus insulin doses quadrupled from 17.1 ± 6.1 U/d to 69.5 ± 29.6 U/d (P = .0001). Bolus insulin increased from approximately 50% of total daily dose of insulin before conception to 75% of total daily dose of insulin at 36 weeks' gestation. CONCLUSION: In well-controlled type 1 diabetes mellitus, insulin requirements increased 3-fold from before conception to 36 weeks' gestation. Most of this requirement was attributed to an increase in bolus rates that are required for control with meals.
Authors: Ravinder Jeet Kaur; Byron H Smith; Basak Ozaslan; Jordan E Pinsker; Mari Charisse Trinidad; Grenye O'Malley; Donna Desjardins; Kristin N Castorino; Camilla Levister; Corey Reid; Shelly McCrady-Spitzer; Selassie J Ogyaadu; Mei Mei Church; Molly Piper; Walter K Kremers; Barak Rosenn; Francis J Doyle; Eyal Dassau; Carol J Levy; Yogish C Kudva Journal: Diabetes Technol Ther Date: 2022-08 Impact factor: 7.337
Authors: Gloria Lekšić; Maja Baretić; Marina Ivanišević; Dubravka Jurišić-Eržen Journal: Int J Environ Res Public Health Date: 2020-09-09 Impact factor: 3.390
Authors: Grenye O'Malley; Basak Ozaslan; Carol J Levy; Kristin Castorino; Donna Desjardins; Camilla Levister; Shelly McCrady-Spitzer; Mei Mei Church; Ravinder Jeet Kaur; Corey Reid; Walter K Kremers; Francis J Doyle; Mari Charisse Trinidad; Barak Rosenn; Jordan E Pinsker; Yogish C Kudva; Eyal Dassau Journal: Diabetes Technol Ther Date: 2021-08-17 Impact factor: 7.337