title: Glycemic control and maternal and fetal outcomes in pregnant women with type 1 diabetes according to the type of basal insulin.
abstract: OBJECTIVE
  To examine the potential role of the type of basal insulin on glycemic control and maternal and foetal outcomes in pregnant women with type 1 diabetes (T1DM).
  
  
  METHODS
  Retrospective cohort study of pregnancies attended at 18 Spanish tertiary hospitals.
  
  
  METHODS
  T1DM, singleton pregnancies, delivery between 2002-2010, and use of the same basal and prandial insulin from before pregnancy until delivery.
  
  
  RESULTS
  A total of 1534 pregnancies were included. The basal insulin most commonly used was Neutral Protamine Hagedorn (NPH) (51.7%), followed by glargine (23.2%) and continuous subcutaneous insulin infusion (CSII) (21.1%). CSII users had longer diabetes duration. Multiple logistic regression analysis showed that CSII was independently associated with lower doses of insulin, higher glycated haemoglobin (HbA1c) in all trimesters, and higher rates of miscarriage, preterm birth and neonatal hypoglycemia. Glargine was related to a higher risk of preterm birth and a small-for-gestational age infant (SGA). The odds ratios (OR) of the associations between insulin type and clinical outcomes (from 0.642 to 4.894) have a relevant magnitude.
  
  
  CONCLUSIONS
  In this observational study of pregnant women with T1DM, the type of basal insulin was independently associated with metabolic variables and foetal outcomes.
authors.affiliation: Department of Endocrinology, Hospital Santa Creu i Sant Pau, Av. Sant Antoni Maria Claret 167, 08025 Barcelona, Spain; CIBER-BBN, Spain; Departament de Medicina, Universitat Autònoma de Barcelona, Av. Sant Antoni Maria Claret 167, 08025 Barcelona, Spain. Electronic address: achicob@santpau.cat.
authors.forename: A
authors.initials: A
authors.lastname: Chico
authors.affiliation: Department of Endocrinology, Hospital La Paz, Paseo de la Castellana 261, 28046 Madrid, Spain. Electronic address: lucherranz.hulp@salud.madrid.org.
authors.forename: L
authors.initials: L
authors.lastname: Herranz
authors.affiliation: Department of Endocrinology, Hospital Santa Creu i Sant Pau, Av. Sant Antoni Maria Claret 167, 08025 Barcelona, Spain; CIBER-BBN, Spain; Departament de Medicina, Universitat Autònoma de Barcelona, Av. Sant Antoni Maria Claret 167, 08025 Barcelona, Spain. Electronic address: rcorcoy@santpau.cat.
authors.forename: R
authors.initials: R
authors.lastname: Corcoy
authors.affiliation: Department of Obstetrics and Gynecology, Hospital Materno-Infantil de Canarias, Av. Marítima Sur, s/n, 35001 Las Palmas de Gran Canaria, Las Palmas, Spain. Electronic address: oramirezg@sego.es.
authors.forename: O
authors.initials: O
authors.lastname: Ramírez
authors.affiliation: Department of Obstetrics, Hospital Vall d'Hebron, Passeig Vall d'Hebron, 119-129, 08035 Barcelona, Spain. Electronic address: mariagoya@mac.com.
authors.forename: M M
authors.initials: MM
authors.lastname: Goya
authors.affiliation: Department of Obstetrics and Gynecology, Hospital Clinic, Sabino Arana, 1,08028 Barcelona, Spain. Electronic address: jbellart@clinic.ub.es.
authors.forename: J
authors.initials: J
authors.lastname: Bellart
authors.affiliation: Department of Endocrinology, Hospital Regional de Málaga, Av. Carlos Haya s/n, 29010 Malaga, Spain. Electronic address: stellagoro@movistar.es.
authors.forename: S
authors.initials: S
authors.lastname: González-Romero
authors.affiliation: Department of Endocrinology, Hospital Son Espases, Carretera de Valldemossa, 79, 07120 Palma, Illes Balears, Spain. Electronic address: mcodinam@binimelis.jazztel.es.
authors.forename: M
authors.initials: M
authors.lastname: Codina
authors.affiliation: Department of Endocrinology, Hospital Gregorio Marañón, Calle del Dr. Esquerdo, 46, 28007 Madrid, Spain. Electronic address: psanchezga.hgugm@salud.madrid.org.
authors.forename: P
authors.initials: P
authors.lastname: Sánchez
authors.affiliation: Department of Endocrinology, Hospital Cruces, Bilbao, Plaza de Cruces, 12, 48903 Barakaldo, Vizcaya, Spain; CIBERDEM, Spain. Electronic address: alicia.cortazargalarza@osakidetza.net.
authors.forename: A
authors.initials: A
authors.lastname: Cortázar
authors.affiliation: Department of Endocrinology, Hospital Virgen del Rocío, Av. Manuel Siurot, s/n, 41013 Sevilla, Spain. Electronic address: dacostadelgado@gmail.com.
authors.forename: D
authors.initials: D
authors.lastname: Acosta
authors.affiliation: Department of Endocrinology, Hospital Virgen de la Victoria, Campus de Teatinos, S/N, 29010 Málaga, Spain. Electronic address: mjpiconcesar@gmail.com.
authors.forename: M J
authors.initials: MJ
authors.lastname: Picón
authors.affiliation: Department of Endocrinology, Hospital Príncipe de Asturias, Carretera Alcalá-Meco, s/n, 28805 Alcalá de Henares, Madrid, Spain. Electronic address: jarubiogarcia@gmail.com.
authors.forename: J A
authors.initials: JA
authors.lastname: Rubio
authors.affiliation: CIBERDEM, Spain; Department of Endocrinology, Hospital Universitari de Tarragona Joan XXIII, C/Dr. Mallafrè Guasch, 4, 43005 Tarragona, Spain; IISPV, Spain; Universitat Rovira I Virgili, C/Dr. Mallafrè Guasch, 4, 43005 Tarragona, Spain. Electronic address: ana.megia@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Megía
authors.affiliation: Department of Endocrinology, Hospital Clinico Lozano Blesa, Avenida San Juan Bosco, 15, 50009 Zaragoza, Spain. Electronic address: ma.sancho@comz.org.
authors.forename: M A
authors.initials: MA
authors.lastname: Sancho
authors.affiliation: Department of Endocrinology, Hospital Mutua de Terrassa, Plaça del Doctor Robert, 5, 08221 Terrassa, Barcelona, Spain. Electronic address: 23591mbc@comb.cat.
authors.forename: M
authors.initials: M
authors.lastname: Balsells
authors.affiliation: Department of Endocrinology, Hospital Dr Peset, Gaspar Aguilar 90, 46017 Valencia, Spain. Electronic address: eva.sola@uv.es.
authors.forename: E
authors.initials: E
authors.lastname: Solá
authors.affiliation: Department of Obstetrics and Gynecology, Hospital Clinico, Ctra. Ofra S/N La Cuesta 38320 La Laguna, Tenerife, Spain. Electronic address: ngonzalezg@sego.es.
authors.forename: N L
authors.initials: NL
authors.lastname: González
authors.affiliation: Department of Endocrinology, Hospital Virgen de la Salud, Avenida de Barber, 30, 45071 Toledo, Spain. Electronic address: jololo@sescam.jccm.es.
authors.forename: J
authors.initials: J
authors.lastname: López-López
mesh_terms: D000328:Adult; D001786:Blood Glucose; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000178:diet therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007231:Infant, Newborn; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D011254:Pregnancy in Diabetics; D012189:Retrospective Studies
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Continuous subcutaneous insulin infusion; Glycated haemoglobin; Insulin analogue; Perinatal outcomes; Pregnancy; Type 1 diabetes