PMID- 27028951
OWN - NLM
STAT- MEDLINE
DCOM- 20171020
LR  - 20171129
IS  - 1557-8593 (Electronic)
IS  - 1520-9156 (Linking)
VI  - 18
IP  - 6
DP  - 2016 Jun
TI  - A Study of the Carbohydrate-to-Insulin Ratio in Pregnant Women with Type 1 
      Diabetes on Pump Treatment.
PG  - 360-5
LID - 10.1089/dia.2015.0246 [doi]
AB  - AIM: The aim of this study was to assess carbohydrate (CHO)-to-insulin ratio 
      (CHO/IR) values in pregnant women with type 1 diabetes and to describe 
      differences in CHO/IR across each week of pregnancy. MATERIALS AND METHODS: This 
      was a multicenter, retrospective, observational study (2006-2012) of 101 white 
      pregnant women with a mean age of 32 (range, 18-43) years who had type 1 diabetes 
      and were under continuous subcutaneous insulin infusion (CSII) therapy. These 
      patients had the following characteristics: type 1 diabetes duration was 1 year 
      (range, 1-31 years), the pregestational glycosylated hemoglobin level was 6.9% 
      (range, 6.8-12.1%), the median weight gain during pregnancy was 14 kg (-3; 
      25 kg), with delivery at 37 weeks (range, 30-40 weeks), and the child had a birth 
      weight of 3.530 kg (range, 1.480-5.250 kg). The CHO/IR was measured by dividing 
      the CHO (in g) of each meal by insulin unit injected to acquire and maintain the 
      following glycemic targets: fasting <90 mg/dL and 1-h postprandial <130 mg/dL. 
      Simultaneously, CHO/IR indices were calculated through 500/total daily doses of 
      insulin and 300/total daily doses of insulin. Education and management before and 
      during pregnancy were in agreement with Italian Association of Dietitians, 
      Association of Medical Diabetologists, and Italian Society of Diabetology 
      recommendations. Data were analyzed using SPSS software (version 20.0; SPSS, 
      Inc., Chicago, IL). RESULTS: The CHO/IR decreased on average from 9.6 (5-18) to 
      5.4 (2.3-8) at breakfast, from 10 (3.5-16) to 8.4 (3.0-17.8) at lunch, and from 
      12.5 (8-20) to 6.1 (4.2-12) at dinner. The CHO/IR calculated using the "500 rule" 
      decreased from 14.3 (10-20.3) to 8.6 (4.1-15.9). Using the "300 rule," the ratios 
      decreased from 8.5 (6-12.1) to 5.2 (2.4-9.5). The bivariate correlation between 
      the values calculated more appropriate values using the "300 rule" for breakfast 
      and the "500 rule" for lunch and dinner across all weeks of pregnancy. 
      CONCLUSIONS: CHO/IR reduction in pregnancy is likely due to an increase in 
      insulin resistance.
FAU - Bongiovanni, Marzia
AU  - Bongiovanni M
AD  - 1 Department of Endocrinology & Diabetology, Faculty of Medicine and Psychology, 
      Sapienza University , Rome, Italy .
FAU - Fresa, Raffaella
AU  - Fresa R
AD  - 2 Department of Endocrinology & Diabetology, District No. 63, Azienda Sanitaria 
      Locale, Salerno, Italy .
FAU - Visalli, Natalia
AU  - Visalli N
AD  - 3 Diabetologic Department, Azienda Sanitaria Locale RME , Rome, Italy .
FAU - Bitterman, Olimpia
AU  - Bitterman O
AD  - 1 Department of Endocrinology & Diabetology, Faculty of Medicine and Psychology, 
      Sapienza University , Rome, Italy .
FAU - Suraci, Concetta
AU  - Suraci C
AD  - 4 Diabetologic Unit, Department of Clinical and Molecular Medicine, S. Pertini 
      Hospital , Rome, Italy .
FAU - Napoli, Angela
AU  - Napoli A
AD  - 1 Department of Endocrinology & Diabetology, Faculty of Medicine and Psychology, 
      Sapienza University , Rome, Italy .
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
DEP - 20160330
PL  - United States
TA  - Diabetes Technol Ther
JT  - Diabetes technology & therapeutics
JID - 100889084
RN  - 0 (Blood Glucose)
RN  - 0 (Carbohydrates)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Algorithms
MH  - Blood Glucose/analysis
MH  - Carbohydrates/*blood
MH  - Diabetes Mellitus, Type 1/*blood/*drug therapy
MH  - Female
MH  - Gestational Age
MH  - Humans
MH  - Hypoglycemic Agents/administration & dosage/*therapeutic use
MH  - Insulin/administration & dosage/*blood/*therapeutic use
MH  - Insulin Infusion Systems
MH  - Meals
MH  - Pregnancy
MH  - Pregnancy in Diabetics/*blood/*drug therapy
MH  - Retrospective Studies
MH  - Young Adult
EDAT- 2016/03/31 06:00
MHDA- 2017/10/21 06:00
CRDT- 2016/03/31 06:00
PHST- 2016/03/31 06:00 [entrez]
PHST- 2016/03/31 06:00 [pubmed]
PHST- 2017/10/21 06:00 [medline]
AID - 10.1089/dia.2015.0246 [doi]
PST - ppublish
SO  - Diabetes Technol Ther. 2016 Jun;18(6):360-5. doi: 10.1089/dia.2015.0246. Epub 
      2016 Mar 30.