Multiple daily injections compared with using an insulin pump in pregnant women with type 1 diabetes

This study compared the effectivess of an insulin pump with multiple daily injections in patients with type 1 diabetes during pregnancy. The study found that women who used MDI had better blood sugar control and lower blood pressure.

Women with type 1 diabetes are able to have babies very safely, as long as their blood sugars are well controlled. HbA1c is a blood measurement of sugar control over 3 months. Two methods currently available for controlling blood sugars are MDI of insulin, or insulin pumps. It is not known if using an insulin pump will be better for the mother and the baby compared to using MDI.

This study consisted of 248 women who were pregnant. All of the women were diagnosed with type 1 diabetes, and had been diagnosed for more than 1 year. 123 of these women used MDI to control their blood sugars. The remaining 125 women used insulin pumps. At the beginning of the study average Hba1c in the women using MDI was 6.84%. At the beginning of the study average Hba1c in the women using insulin pumps was 6.95%.

The women were followed to the end of their pregnancy. Overall, the women on MDI had better blood sugars than those using insulin pumps. After 34 weeks of pregnancy the women using MDI improved their Hba1c by an average of 0.55%. After 34 weeks of pregnancy the women using insulin pumps improved their Hba1c by an average of 0.32%. The women using insulin pumps were more likely to have high blood pressure than the women using MDI. The babies that were born to the women using insulin pumps were more likely to be born with low blood sugar than those born to the women using MDI. There was a higher chance that the babies born to the women using insulin pumps had to be admitted to intensive care compared to the babies born to women using MDI. The women using insulin pumps reported that they were less scared about having low blood sugars compared to the women using MDI. The women using insulin pumps said they felt less healthy compared with the women using MDI.

The study concluded that using MDI during pregnancy is better for controlling the blood sugar of the mother, and for the baby in its first few days of life, compared to using insulin pumps women with type 1 diabetes.

This is a small study. There are a lot of factors that affect how someone controls their blood sugars. Not all these factors could be measured in this study. Funding of insulin pumps in different areas was also not considered in this study.

If you are planning on becoming pregnant, talk to your diabetes doctor about your options.