title: Changes in basal rates and bolus calculator settings in insulin pumps during pregnancy in women with type 1 diabetes.
abstract: OBJECTIVE
  To explore insulin pump settings in a cohort of pregnant women with type 1 diabetes on insulin pump therapy with a bolus calculator.
  
  
  METHODS
  Twenty-seven women with type 1 diabetes on insulin pump therapy were included in this study. At 8, 12, 21, 27 and 33 weeks, insulin pump settings and HbA1c were recorded. Results were compared with 96 women with type 1 diabetes on multiple daily injection therapy.
  
  
  RESULTS
  Throughout pregnancy, the carbohydrate-to-insulin ratio decreased at all three main meals. The most pronounced decrease was observed at breakfast, where the carbohydrate-to-insulin ratio was reduced, from median 12 (range 4-20) in early pregnancy to 3 (2-10) g carbohydrate per unit insulin in late pregnancy. Basal insulin delivery increased by ∼50%, i.e. from 0.8 (0.5-2.2) to 1.2 (0.6-2.5) IU/h at 5 a.m. and from 1.0 (0.6-1.5) to 1.3 (0.2-2.3) IU/h at 5 p.m. during pregnancy. HbA1c levels during pregnancy, the occurrence of severe hypoglycemia and pregnancy outcomes were similar in the two groups.
  
  
  CONCLUSIONS
  In women with type 1 diabetes on insulin pump therapy with a bolus calculator, the carbohydrate-to-insulin ratio declined 4-fold from early to late pregnancy, whereas changes in basal insulin delivery were smaller.
authors: Center for Pregnant Women with Diabetes, Rigshospitalet , Blegdamsvej, Copenhagen , Denmark .
authors: Jonathan M
authors: JM
authors: Mathiesen
authors: Anna L
authors: AL
authors: Secher
authors: Lene
authors: L
authors: Ringholm
authors: Kirsten
authors: K
authors: Nørgaard
authors: Eva
authors: E
authors: Hommel
authors: Henrik U
authors: HU
authors: Andersen
authors: Peter
authors: P
authors: Damm
authors: Elisabeth R
authors: ER
authors: Mathiesen
mesh_terms: D000465:Algorithms; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007328:Insulin / Q000008:administration & dosage*; D007332:Insulin Infusion Systems; D011247:Pregnancy; D011254:Pregnancy in Diabetics
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin