title: Level of glycemic control and pregnancy outcome in type 1 diabetes: a comparison between multiple daily insulin injections and continuous subcutaneous insulin infusions.
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).
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors: Perinatal Division and World Health Organization Collaborating Center, Helen Schneider Hospital for Women, Rabin Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: Rony
authors: R
authors: Chen
authors: Avi
authors: A
authors: Ben-Haroush
authors: Alina
authors: A
authors: Weismann-Brenner
authors: Alina
authors: A
authors: Weissman-Brenner
authors: Nir
authors: N
authors: Melamed
authors: Moshe
authors: M
authors: Hod
authors: Yariv
authors: Y
authors: Yogev
mesh_terms: D000328:Adult; D001724:Birth Weight; D001786:Blood Glucose / Q000378:metabolism; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D016883:Diabetic Ketoacidosis / Q000517:prevention & control; D005260:Female; D005865:Gestational Age; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007003:Hypoglycemia / Q000517:prevention & control; D007231:Infant, Newborn; D007279:Injections, Subcutaneous; D007328:Insulin / Q000008:administration & dosage*; D007332:Insulin Infusion Systems; D011247:Pregnancy; D011256:Pregnancy Outcome; D011254:Pregnancy in Diabetics / Q000097:blood / Q000188:drug therapy*; D012189:Retrospective Studies
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin