In a nutshell
This study examined whether pregnant women who use an insulin pump have better control of blood glucose levels and better pregnancy outcomes in comparison to those using multiple daily injections.
Some background
80% of infants born to women with type 1 diabetes (T1D) have at least one complication associated with maternal diabetes. High blood sugar levels in the mother can lead to fetal complications such as stillbirth and a large-for-gestational-age (LGA) infant (meaning babies are bigger than normal at birth). Effective management of blood sugar levels during pregnancy can reduce complications in infants. It is not yet clear whether this is better achieved using an insulin pump (allows the patient to enter the carbohydrate content of a meal following which insulin is released) or using multiple daily injections (MDI) of insulin.
Methods & findings
This study aimed to compare blood glucose levels and pregnancy outcomes in women using an insulin pump and those using MDIs. This study involved 387 pregnant T1D patients divided into 2 groups. 129 participants used an insulin pump and 258 uses MDIs. HbA1c (a measurement of blood glucose [sugar] over the previous 3 months) was measured during each trimester.
Women using an insulin pump had a lower HbA1c during all trimesters in comparison to those using MDIs. In semester one those using an insulin pump had an average HbA1c of 6.9% compared to 7.6% in those using MDI. In semester three those using an insulin pump had an average HbA1c of 6.49% compared to 6.81%.
The frequency of diabetic ketoacidosis (a condition that occurs when the cells of the body do not get enough sugar for energy and the body begins to burn fat) and the frequency of hypoglycaemia (dangerously low blood sugar levels) was similar in both groups. Weight gain, the number of Caeserean sections (delivery of infant through surgical incision in abdomen) and the number of LGA infants were also similar in both groups.
The bottom line
This study concluded that women who use an insulin pump during pregnancy have improved blood sugar levels.
The fine print
Diabetes complications, spontaneous abortions and severe hypoglycemia may have been underreported.
What’s next?
Consult your physician regarding the benefits of using an insulin pump during pregnancy.
Published By :
Diabetologia
Date :
Jan 17, 2014
