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Type 1 diabetes control and pregnancy outcomes in women treated with continuous subcutaneous insulin infusion (CSII) or with insulin glargine and multiple daily injections of rapid-acting insulin analogues (glargine-MDI).
Diabetes Metab. 2011 Nov; 37(5):426-31.DM

Abstract

AIM

The best way to treat pregnant patients who have type 1 diabetes is still unclear. For this reason, the present study compared metabolic control and maternal-fetal outcomes in patients treated with continuous subcutaneous infusions of rapid-acting insulin analogues (CSII) or with insulin glargine and multiple daily injections of rapid-acting insulin analogues (glargine-MDI).

METHODS

This retrospective multicentre study involved 144 women with type 1 diabetes, 100 of whom were using CSII and 44 glargine-MDI. Outcomes analyzed were metabolic control, diabetes complications, pregnancy outcome, perinatal morbidity and mortality, and fetal malformations.

RESULTS

The two groups were comparable for age, prepregnancy BMI, primiparous rate and diabetes complications, although patients using CSII had longer duration of diabetes (P=0.03) and higher White classifications (P=0.04). In both groups, metabolic control improved during pregnancy, but good control was reached earlier among patients using CSII. At parturition, patients using CSII had lower HbA(1c) (6.2±0.7% vs 6.5±0.8%; P=0.02) and required less insulin (P<0.01). Weight gain was similar in both groups, and maternal-fetal outcomes did not differ.

CONCLUSION

In pregnant patients with type 1 diabetes, MDI and CSII are equivalent in terms of metabolic control and fetal-maternal outcomes, although patients using CSII achieved good control earlier and with less insulin.

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Authors+Show Affiliations

Bruttomesso D
Department of Clinical and Experimental Medicine, University of Padova, Padova, Italy. daniela.bruttomesso@unipd.it
Bonomo M
No affiliation info available
Costa S
No affiliation info available
Dal Pos M
No affiliation info available
Di Cianni G
No affiliation info available
Pellicano F
No affiliation info available
Vitacolonna E
No affiliation info available
Dodesini AR
No affiliation info available
Tonutti L
No affiliation info available
Lapolla A
No affiliation info available
Di Benedetto A
No affiliation info available
Torlone E
No affiliation info available
Italian Group for Continuous Subcutaneous Insulin Infusion in Pregnancy
No affiliation info available

MeSH

AdultDiabetes ComplicationsDiabetes Mellitus, Type 1FemaleFetal DiseasesHumansHypoglycemic AgentsInfant, NewbornInfusions, SubcutaneousInsulin GlargineInsulin Infusion SystemsInsulin, Long-ActingMorbidityPregnancyPregnancy OutcomePregnancy in DiabeticsRetrospective Studies

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study

Language

eng

PubMed ID

21474360

Citation

Bruttomesso, D, et al. "Type 1 Diabetes Control and Pregnancy Outcomes in Women Treated With Continuous Subcutaneous Insulin Infusion (CSII) or With Insulin Glargine and Multiple Daily Injections of Rapid-acting Insulin Analogues (glargine-MDI)." Diabetes & Metabolism, vol. 37, no. 5, 2011, pp. 426-31.
Bruttomesso D, Bonomo M, Costa S, et al. Type 1 diabetes control and pregnancy outcomes in women treated with continuous subcutaneous insulin infusion (CSII) or with insulin glargine and multiple daily injections of rapid-acting insulin analogues (glargine-MDI). Diabetes Metab. 2011;37(5):426-31.
Bruttomesso, D., Bonomo, M., Costa, S., Dal Pos, M., Di Cianni, G., Pellicano, F., Vitacolonna, E., Dodesini, A. R., Tonutti, L., Lapolla, A., Di Benedetto, A., & Torlone, E. (2011). Type 1 diabetes control and pregnancy outcomes in women treated with continuous subcutaneous insulin infusion (CSII) or with insulin glargine and multiple daily injections of rapid-acting insulin analogues (glargine-MDI). Diabetes & Metabolism, 37(5), 426-31. https://doi.org/10.1016/j.diabet.2011.02.002
Bruttomesso D, et al. Type 1 Diabetes Control and Pregnancy Outcomes in Women Treated With Continuous Subcutaneous Insulin Infusion (CSII) or With Insulin Glargine and Multiple Daily Injections of Rapid-acting Insulin Analogues (glargine-MDI). Diabetes Metab. 2011;37(5):426-31. PubMed PMID: 21474360.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Type 1 diabetes control and pregnancy outcomes in women treated with continuous subcutaneous insulin infusion (CSII) or with insulin glargine and multiple daily injections of rapid-acting insulin analogues (glargine-MDI). AU - Bruttomesso,D, AU - Bonomo,M, AU - Costa,S, AU - Dal Pos,M, AU - Di Cianni,G, AU - Pellicano,F, AU - Vitacolonna,E, AU - Dodesini,A R, AU - Tonutti,L, AU - Lapolla,A, AU - Di Benedetto,A, AU - Torlone,E, AU - ,, Y1 - 2011/04/06/ PY - 2010/11/28/received PY - 2011/02/01/revised PY - 2011/02/02/accepted PY - 2011/4/9/entrez PY - 2011/4/9/pubmed PY - 2012/1/6/medline SP - 426 EP - 31 JF - Diabetes & metabolism JO - Diabetes Metab VL - 37 IS - 5 N2 - AIM: The best way to treat pregnant patients who have type 1 diabetes is still unclear. For this reason, the present study compared metabolic control and maternal-fetal outcomes in patients treated with continuous subcutaneous infusions of rapid-acting insulin analogues (CSII) or with insulin glargine and multiple daily injections of rapid-acting insulin analogues (glargine-MDI). METHODS: This retrospective multicentre study involved 144 women with type 1 diabetes, 100 of whom were using CSII and 44 glargine-MDI. Outcomes analyzed were metabolic control, diabetes complications, pregnancy outcome, perinatal morbidity and mortality, and fetal malformations. RESULTS: The two groups were comparable for age, prepregnancy BMI, primiparous rate and diabetes complications, although patients using CSII had longer duration of diabetes (P=0.03) and higher White classifications (P=0.04). In both groups, metabolic control improved during pregnancy, but good control was reached earlier among patients using CSII. At parturition, patients using CSII had lower HbA(1c) (6.2±0.7% vs 6.5±0.8%; P=0.02) and required less insulin (P<0.01). Weight gain was similar in both groups, and maternal-fetal outcomes did not differ. CONCLUSION: In pregnant patients with type 1 diabetes, MDI and CSII are equivalent in terms of metabolic control and fetal-maternal outcomes, although patients using CSII achieved good control earlier and with less insulin. SN - 1878-1780 UR - https://www.unboundmedicine.com/medline/citation/21474360/Type_1_diabetes_control_and_pregnancy_outcomes_in_women_treated_with_continuous_subcutaneous_insulin_infusion__CSII__or_with_insulin_glargine_and_multiple_daily_injections_of_rapid_acting_insulin_analogues__glargine_MDI__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1262-3636(11)00042-5 DB - PRIME DP - Unbound Medicine ER -