Continuous subcutaneous insulin infusion versus multiple daily injections in pregnant women with type 1 diabetes.
BACKGROUND
Continuous subcutaneous insulin infusion (CSII) may be an alternative to multiple daily injections (MDI) in pre-gestational diabetes during pregnancy. However, no clear improvement in obstetric and perinatal outcome has so far been established for CSII treatment.


METHODS
In a case-control study, 35 pregnancies treated with CSII and 64 pregnancies treated with MDI treatment were evaluated. Metabolic control and obstetric and perinatal outcome were compared.


RESULTS
Women in the CSII group improved their metabolic control (hemoglobin A1c before CSII, 7.83 +/- 0.97%; 3-6 months after, 6.77 +/- 0.61%; P < 0.05). Hemoglobin A1c before pregnancy was lower in the CSII group (6.62 +/- 0.60%) than in the MDI group (7.59 +/- 1.61%) (P < 0.05). No other significant differences, either in metabolic control of diabetes or in obstetric and perinatal outcome, were found.


CONCLUSIONS
CSII treatment is safe in pregnancy, but it has not yet been associated with any improved pregnancy outcome.
González-Romero
Stella
S
Endocrinology and Nutrition, Hospital Regional Universitario Carlos Haya, Avenida del Dr. Gálvez Ginachero S/N, Malaga, Spain. stellagr@telefonica.net
González-Molero
Inmaculada
I
Fernández-Abellán
Micaela
M
Domínguez-López
Marta E
ME
Ruiz-de-Adana
Soledad
S
Olveira
Gabriel
G
Soriguer
Federico
F
D000328:Adult; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007267:Injections; D007328:Insulin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D007332:Insulin Infusion Systems; D061268:Insulin Lispro; D011247:Pregnancy; D011254:Pregnancy in Diabetics; D055815:Young Adult
D007004:Hypoglycemic Agents; D007328:Insulin; D061268:Insulin Lispro