title: Multiple daily injections of insulin versus continuous subcutaneous insulin infusion for pregnant women with type 1 diabetes.
abstract: OBJECTIVE
  The aim was to evaluate the outcome of pregnancies with type 1 diabetes (T1DM) treated from the first trimester with continuous subcutaneous insulin infusion (CSII) or multiple daily injections (MDI).
  
  
  METHODS
  In a retrospective, observational study, we matched 64 CSII patients for age, age at onset and duration of diabetes and HbA1c in the first trimester with 64 MDI pregnancies. We analysed carbohydrate metabolism, insulin requirements, development of PIH, progression of retinopathy and fetal outcome.
  
  
  RESULTS
  In CSII group, we found a significantly smaller insulin requirement both at the beginning of pregnancy and before delivery, significant decrease in HbA1c levels and significantly smaller number of hypoglycaemic episodes in the second trimester and significantly more hyperglycaemic episodes in the first trimester. In both groups, maternal, fetal and perinatal outcomes were similar and the number of hypo- and hyperglycaemic episodes decreased throughout pregnancy.
  
  
  CONCLUSIONS
  Continuous subcutaneous insulin infusion (CSII) treatment in pregnant women with type 1 diabetes is associated with a reduced number of hypoglycaemia and decreased insulin requirement. We noted no difference in perinatal outcome comparing women on multiple insulin injections with those on continuous insulin infusion.
authors: Department of Obstetrics and Women Diseases, Poznan University of Medical Sciences, Poznan, Poland. ewaoz@post.pl
authors: Ewa
authors: E
authors: Wender-Ozegowska
authors: Agnieszka
authors: A
authors: Zawiejska
authors: Katarzyna
authors: K
authors: Ozegowska
authors: Katarzyna
authors: K
authors: Wroblewska-Seniuk
authors: Rafal
authors: R
authors: Iciek
authors: Urszula
authors: U
authors: Mantaj
authors: Danuta
authors: D
authors: Olejniczak
authors: Jacek
authors: J
authors: Brazert
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D055104:Infusions, Subcutaneous; D007279:Injections, Subcutaneous; D007328:Insulin / Q000008:administration & dosage*; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000097:blood / Q000188:drug therapy*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin