Level of glycemic control and pregnancy outcome in type 1 diabetes: a comparison between multiple daily insulin injections and continuous subcutaneous insulin infusions

Rony Chen, Avi Ben-Haroush, Alina Weissman-Brenner, Nir Melamed, Moshe Hod, Yariv Yogev

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: We aimed to compare glycemic control and pregnancy outcome in type I diabetic patients treated by 2 modes of treatment: multiple daily injections of insulin (MDI) and continuous subcutaneous insulin infusions (CSII). Study Design: In a retrospective, matched-control study, patients treated by MDI were compared with patients treated by CSII in a ratio of 2:1. Level of glycemic control and pregnancy outcome was compared. Results: Overall, 90 women were evaluated; of them 30 were treated by CSII and 60 by MDI. No between-group differences were found in maternal age, nulliparity rate, severity and duration of diabetes, prepregnancy body mass index, and weight gain during pregnancy. The rate of diabetic ketoacidosis (DKA) and neonatal hypoglycemia were significantly higher in the CSII group (13% vs 2%, P = .04) and (35% vs 13%, P = .01), respectively. No significant differences were found in pregnancy outcome measures. Conclusion: In type 1 diabetes, glycemic control and pregnancy outcome are compromised, regardless of treatment modality. CSII may be associated with higher rate of both maternal DKA and neonatal hypoglycemic events.

Original languageEnglish
Pages (from-to)404.e1-404.e5
JournalAmerican Journal of Obstetrics and Gynecology
Volume197
Issue number4
DOIs
StatePublished - Oct 2007
Externally publishedYes

Keywords

  • glycemic control
  • insulin pump
  • pregnancy
  • type 1 diabetes

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