Level of glycemic control and pregnancy outcome in type 1 diabetes: a comparison between multiple daily insulin injections and continuous subcutaneous insulin infusions.
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.
Chen
Rony
R
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.
Ben-Haroush
Avi
A
Weismann-Brenner
Alina
A
Weissman-Brenner
Alina
A
Melamed
Nir
N
Hod
Moshe
M
Yogev
Yariv
Y
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
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin