title: [Use of continuous subcutaneous insulin infusion by a portable insulin pump during pregnancy in women with type 1 diabetes mellitus].
abstract: OBJECTIVE
  Diabetes mellitus is associated with an increased risk for neonatal morbidity and mortality. One of the most important goals in treating pregnancies complicated with diabetes is keeping glucose level within the normal range, especially in the first trimester. A portable insulin pump for continuous subcutaneous insulin infusion (CSII) represents the best form of therapy for patients with type 1 diabetes mellitus during pregnancy. The aim of our study was to evaluate the effects of therapy with a portable insulin pump for continuous subcutaneous insulin infusion during the first trimester of pregnancy on the quality of glycoregulation and pregnancy outcome in women with type 1 diabetes mellitus.
  
  
  METHODS
  A total of 17 newly diagnosed pregnant women with type 1 diabetes mellitus were treated with CSII therapy for three months. The parameters of glycoregulation (hemoglobin A, glycosylated--HbAlc, mean blood glucose value in daily profiles--MBG, daily requirement for insulin--IJ/kg BM), lipid levels, blood preassure and renal function were estimated before and after the therapy. These parameters were correlated with parameters of pregnancy outcome: fetal weight, APGAR score, duration of pregnancy.
  
  
  RESULTS
  There was a significant improvement in HbA1c (8.94 +/- 1.62 vs. 6.90 +/- 1.22 %,p < 0.05), MBG (9.23 +/- 2.22 vs. 6.41 +/- 1.72 mmol/l, p < 0.01), and daily requirement for insulin (0.66 +/- 0.22 vs. 0.55 +/- 0.13 IJ/kg BM, p < 0.05) during the CSII therapy. There were significant correlations between fetal weight and HbAlc (r = -0.60, p < 0.05), triglyceride levels (r = -0.63, p < 0.01), and the number of pregnancies (r = -0.62, p < 0.01), as well as between APGAR score and MBG (r = -0.52, p < 0.05) and cholesterol levels (r = -0.65, p < 0,01) before a portable insulin pump was applicated.
  
  
  CONCLUSIONS
  There was a significant improvement in the quality of glycoregulation during CSII therapy in the pregnant women with type 1 diabetes mellitus. The quality of glycoregulation in the moment of conception was the important factor for pregnancy outcome.
authors.affiliation: Klinicki centar Srbije, Institut za endokrinologiju, dijabetes i bolesti metabolizma, Beograd. micied@Eunet.yu
authors.forename: Svetlana
authors.initials: S
authors.lastname: Zorić
authors.forename: Dragan
authors.initials: D
authors.lastname: Micić
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Kendereski
authors.forename: Mirjana
authors.initials: M
authors.lastname: Sumarac-Dumanović
authors.forename: Goran
authors.initials: G
authors.lastname: Cvijović
authors.forename: Danica
authors.initials: D
authors.lastname: Pejković
authors.forename: Milos
authors.initials: M
authors.lastname: Cvetković
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Ljubić
authors.forename: Jelena
authors.initials: J
authors.lastname: Dukanac-Stamenković
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007332:Insulin Infusion Systems; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000188:drug therapy*
chemical_list: D001786:Blood Glucose