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

Am J Obstet Gynecol. 2007 Oct;197(4):404.e1-5. doi: 10.1016/j.ajog.2007.06.007.

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.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Birth Weight
  • Blood Glucose / metabolism
  • Case-Control Studies
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Diabetic Ketoacidosis / prevention & control
  • Female
  • Gestational Age
  • Glycated Hemoglobin / metabolism
  • Humans
  • Hypoglycemia / prevention & control
  • Infant, Newborn
  • Injections, Subcutaneous
  • Insulin / administration & dosage*
  • Insulin Infusion Systems
  • Pregnancy
  • Pregnancy Outcome
  • Pregnancy in Diabetics / blood
  • Pregnancy in Diabetics / drug therapy*
  • Retrospective Studies

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • Insulin