Continuous subcutaneous insulin infusion versus multiple daily injections in pregnant women with type 1 diabetes

Diabetes Technol Ther. 2010 Apr;12(4):263-9. doi: 10.1089/dia.2009.0140.

Abstract

Background: Continuous subcutaneous insulin infusion (CSII) may be an alternative to multiple daily injections (MDI) in pre-gestational diabetes during pregnancy. However, no clear improvement in obstetric and perinatal outcome has so far been established for CSII treatment.

Methods: In a case-control study, 35 pregnancies treated with CSII and 64 pregnancies treated with MDI treatment were evaluated. Metabolic control and obstetric and perinatal outcome were compared.

Results: Women in the CSII group improved their metabolic control (hemoglobin A1c before CSII, 7.83 +/- 0.97%; 3-6 months after, 6.77 +/- 0.61%; P < 0.05). Hemoglobin A1c before pregnancy was lower in the CSII group (6.62 +/- 0.60%) than in the MDI group (7.59 +/- 1.61%) (P < 0.05). No other significant differences, either in metabolic control of diabetes or in obstetric and perinatal outcome, were found.

Conclusions: CSII treatment is safe in pregnancy, but it has not yet been associated with any improved pregnancy outcome.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Case-Control Studies
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Female
  • Humans
  • Hypoglycemic Agents / administration & dosage*
  • Injections
  • Insulin / administration & dosage
  • Insulin / analogs & derivatives*
  • Insulin Infusion Systems*
  • Insulin Lispro
  • Pregnancy
  • Pregnancy in Diabetics*
  • Young Adult

Substances

  • Hypoglycemic Agents
  • Insulin
  • Insulin Lispro