TY - JOUR
T1 - Macrosomia in well controlled CSII treated Type I diabetic pregnancy
AU - Cohen, Ohad
AU - Keidar, Naomi
AU - Simchen, Michal
AU - Weisz, Boaz
AU - Dolitsky, Mordechai
AU - Sivan, Eyal
PY - 2008
Y1 - 2008
N2 - Objective. To survey the effect of tight glycemic control by insulin pumps, of pre-gestational Type 1 diabetic women on pregnancy outcome. Methods. Twelve consecutive Type 1, insulin pump treated, diabetic patients followed in the high risk maternal - fetal clinic were ascertained. Data regarding glucose control was assessed and correlated with pregnancy outcome. Results. A total of 14 deliveries (10 singleton) were assessed. There were no miscarriages, one baby that was born with a ventricular septal defect (VSD). Glycemic control was within the acceptable guidelines. HbA1c (%) by trimesters: 6.5 ± 0.9, 5.9 ± 0.7, 5.8 ± 0.6 and average glucose (mg/dL) 121.0 ± 15.2, 114.8 ± 13.2, 116.0 ± 21.1. Average birth weight was 3312.1 ± 750.2 g with five babies (35%) weighting over 4.0 kg at birth. Birth weight was significantly correlated with HbA1c at the first trimester, mean glucose at trimester 1 and 2, and maternal weight at delivery (r = 0.74, p = 0.045; r = 0.72, p = 0.051; r = 0.74, p = 0.046; r = 0.74, p = 0.04, respectively). Conclusions. Our study of a limited number of patients suggest that women with pre-gestational diabetes obtaining acceptable glycemic goals with insulin pump therapy have increased risk of macrosomia. Current glycemic goals and therapies in treating pre-gestational diabetic patients therefore might not be sufficient to normalise pregnancy outcomes in of women with pre-gestational diabetes.
AB - Objective. To survey the effect of tight glycemic control by insulin pumps, of pre-gestational Type 1 diabetic women on pregnancy outcome. Methods. Twelve consecutive Type 1, insulin pump treated, diabetic patients followed in the high risk maternal - fetal clinic were ascertained. Data regarding glucose control was assessed and correlated with pregnancy outcome. Results. A total of 14 deliveries (10 singleton) were assessed. There were no miscarriages, one baby that was born with a ventricular septal defect (VSD). Glycemic control was within the acceptable guidelines. HbA1c (%) by trimesters: 6.5 ± 0.9, 5.9 ± 0.7, 5.8 ± 0.6 and average glucose (mg/dL) 121.0 ± 15.2, 114.8 ± 13.2, 116.0 ± 21.1. Average birth weight was 3312.1 ± 750.2 g with five babies (35%) weighting over 4.0 kg at birth. Birth weight was significantly correlated with HbA1c at the first trimester, mean glucose at trimester 1 and 2, and maternal weight at delivery (r = 0.74, p = 0.045; r = 0.72, p = 0.051; r = 0.74, p = 0.046; r = 0.74, p = 0.04, respectively). Conclusions. Our study of a limited number of patients suggest that women with pre-gestational diabetes obtaining acceptable glycemic goals with insulin pump therapy have increased risk of macrosomia. Current glycemic goals and therapies in treating pre-gestational diabetic patients therefore might not be sufficient to normalise pregnancy outcomes in of women with pre-gestational diabetes.
KW - CSII
KW - Diabetes
KW - Macrosomia
UR - http://www.scopus.com/inward/record.url?scp=56749133073&partnerID=8YFLogxK
U2 - 10.1080/09513590802531062
DO - 10.1080/09513590802531062
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C2 - 19031216
AN - SCOPUS:56749133073
SN - 0951-3590
VL - 24
SP - 611
EP - 613
JO - Gynecological Endocrinology
JF - Gynecological Endocrinology
IS - 11
ER -