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Is there a difference in pregnancy and glycemic outcome in patients with type 1 diabetes on insulin pump with constant or intermittent glucose monitoring? A pilot study.
Diabetes Technol Ther. 2011 Nov; 13(11):1109-13.DT

Abstract

BACKGROUND

The aim of the study is to describe glycemic and insulin outcomes by trimester and maternal and fetal outcome in patients with type 1 diabetes using an insulin pump with constant or intermittent continuous glucose monitoring (CGM).

METHODS

Twenty-five women with type 1 diabetes with newly diagnosed pregnancy were treated with insulin pump therapy (Medtronic 722, Medtronic Minimed, Northridge, CA) for at least 1 year. Insulin pump and CGM (Medtronic Paradigm Real-Time) were implemented at least 3 months before conception. Patients were randomized in two groups: constant CGM group, 12 patients on insulin pump with glucose sensor, 24 h/day; and intermittent CGM group, 13 patients on insulin pump with intermittent glucose sensor, 14 days/month. The following parameters were analyzed: glycosylated hemoglobin (HbA1c), mean blood glucose, insulin requirement (in IU/kg/day), weight gain, severe hypoglycemic events, diabetic ketoacidosis, macrosomia, cesarean section, and neonatal hypoglycemia.

RESULTS

Both groups achieved good glucose control during their pregnancies (P<0.05): 6.78±1.3% and 6.92±0.9% at the beginning of the study compared with 6.14±0.9% (constant CGM group) and 6.23±0.6% (intermittent CGM group) at the end of the study (last HbA1c before delivery). There was no significant decrease of HbA1c between the two groups. The constant CGM group had a significantly lower A1c in the first trimester compared with the intermittent CGM group. Maternal and fetal outcome did not show a significant difference between the two groups.

CONCLUSIONS

Insulin pump therapy together with constant or intermittent CGM can improve diabetes control and pregnancy outcome in type 1 diabetes. The quality of the glucose profile at conception was the important factor for pregnancy outcome.

Authors+Show Affiliations

University Clinic of Endocrinology, Diabetes and Metabolic Disorders, Medical Faculty, Skopje, Macedonia. goranp@endocrinology.org.mkNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21751889

Citation

Petrovski, Goran, et al. "Is There a Difference in Pregnancy and Glycemic Outcome in Patients With Type 1 Diabetes On Insulin Pump With Constant or Intermittent Glucose Monitoring? a Pilot Study." Diabetes Technology & Therapeutics, vol. 13, no. 11, 2011, pp. 1109-13.
Petrovski G, Dimitrovski C, Bogoev M, et al. Is there a difference in pregnancy and glycemic outcome in patients with type 1 diabetes on insulin pump with constant or intermittent glucose monitoring? A pilot study. Diabetes Technol Ther. 2011;13(11):1109-13.
Petrovski, G., Dimitrovski, C., Bogoev, M., Milenkovic, T., Ahmeti, I., & Bitovska, I. (2011). Is there a difference in pregnancy and glycemic outcome in patients with type 1 diabetes on insulin pump with constant or intermittent glucose monitoring? A pilot study. Diabetes Technology & Therapeutics, 13(11), 1109-13. https://doi.org/10.1089/dia.2011.0081
Petrovski G, et al. Is There a Difference in Pregnancy and Glycemic Outcome in Patients With Type 1 Diabetes On Insulin Pump With Constant or Intermittent Glucose Monitoring? a Pilot Study. Diabetes Technol Ther. 2011;13(11):1109-13. PubMed PMID: 21751889.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Is there a difference in pregnancy and glycemic outcome in patients with type 1 diabetes on insulin pump with constant or intermittent glucose monitoring? A pilot study. AU - Petrovski,Goran, AU - Dimitrovski,Cedomir, AU - Bogoev,Milco, AU - Milenkovic,Tatjana, AU - Ahmeti,Irfan, AU - Bitovska,Iskra, Y1 - 2011/07/13/ PY - 2011/7/15/entrez PY - 2011/7/15/pubmed PY - 2012/4/3/medline SP - 1109 EP - 13 JF - Diabetes technology & therapeutics JO - Diabetes Technol Ther VL - 13 IS - 11 N2 - BACKGROUND: The aim of the study is to describe glycemic and insulin outcomes by trimester and maternal and fetal outcome in patients with type 1 diabetes using an insulin pump with constant or intermittent continuous glucose monitoring (CGM). METHODS: Twenty-five women with type 1 diabetes with newly diagnosed pregnancy were treated with insulin pump therapy (Medtronic 722, Medtronic Minimed, Northridge, CA) for at least 1 year. Insulin pump and CGM (Medtronic Paradigm Real-Time) were implemented at least 3 months before conception. Patients were randomized in two groups: constant CGM group, 12 patients on insulin pump with glucose sensor, 24 h/day; and intermittent CGM group, 13 patients on insulin pump with intermittent glucose sensor, 14 days/month. The following parameters were analyzed: glycosylated hemoglobin (HbA1c), mean blood glucose, insulin requirement (in IU/kg/day), weight gain, severe hypoglycemic events, diabetic ketoacidosis, macrosomia, cesarean section, and neonatal hypoglycemia. RESULTS: Both groups achieved good glucose control during their pregnancies (P<0.05): 6.78±1.3% and 6.92±0.9% at the beginning of the study compared with 6.14±0.9% (constant CGM group) and 6.23±0.6% (intermittent CGM group) at the end of the study (last HbA1c before delivery). There was no significant decrease of HbA1c between the two groups. The constant CGM group had a significantly lower A1c in the first trimester compared with the intermittent CGM group. Maternal and fetal outcome did not show a significant difference between the two groups. CONCLUSIONS: Insulin pump therapy together with constant or intermittent CGM can improve diabetes control and pregnancy outcome in type 1 diabetes. The quality of the glucose profile at conception was the important factor for pregnancy outcome. SN - 1557-8593 UR - https://www.unboundmedicine.com/medline/citation/21751889/Is_there_a_difference_in_pregnancy_and_glycemic_outcome_in_patients_with_type_1_diabetes_on_insulin_pump_with_constant_or_intermittent_glucose_monitoring_A_pilot_study_ L2 - https://www.liebertpub.com/doi/10.1089/dia.2011.0081?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -