PMID- 28282241
OWN - NLM
STAT- MEDLINE
DCOM- 20180312
LR  - 20221207
IS  - 1557-8593 (Electronic)
IS  - 1520-9156 (Linking)
VI  - 19
IP  - 5
DP  - 2017 May
TI  - Pregnancy Outcomes and Insulin Requirements in Women with Type 1 Diabetes Treated 
      with Continuous Subcutaneous Insulin Infusion and Multiple Daily Injections: 
      Cohort Study.
PG  - 280-287
LID - 10.1089/dia.2016.0412 [doi]
AB  - BACKGROUND: We aimed to compare glycemic control, insulin requirements, and 
      outcomes in women with type 1 diabetes in pregnancy treated with continuous 
      subcutaneous insulin infusion (CSII) and multiple daily injections (MDI). 
      METHODS: A retrospective cohort study was conducted of singleton pregnancies (>20 
      weeks gestation) in women with type 1 diabetes (2010-2015) at a specialist 
      multidisciplinary maternity network in Australia. Antenatal characteristics, 
      diabetes history and treatment details, and maternal and neonatal outcomes were 
      compared for women with type 1 diabetes using CSII and MDI. Bolus calculator 
      settings were reviewed for CSII. Data were obtained from individual medical 
      records, linkage to pathology, and the Birthing Outcomes System database. 
      RESULTS: There were no differences in maternal characteristics or diabetes 
      history between women managed with CSII (n = 40) and MDI (n = 127). Women treated 
      with CSII required less insulin and less increase in total daily insulin dose/kg 
      than MDI (40% vs. 52%). Both groups achieved similar glycemic control and no 
      differences in pregnancy outcome. In the CSII group, carbohydrate:insulin ratios 
      were intensified across gestation (30% breakfast, 27% lunch, 22% dinner), and 
      insulin sensitivity factors (ISFs) changed little (7% breakfast, 0% lunch, -10% 
      dinner). CONCLUSIONS: There was no difference in glycemic control or pregnancy 
      outcomes in women using CSII or MDI managed in a multidisciplinary setting. 
      Greater adjustments are needed to ISFs with CSII therapy. Overall, these data do 
      not support recommending CSII in pregnancy with potentially higher patient and 
      staff demands and costs and lack of improvement in HbA1c and pregnancy outcomes.
FAU - Abell, Sally K
AU  - Abell SK
AD  - 1 Monash Centre for Health Research and Implementation, School of Public Health 
      and Preventive Medicine, Monash University , Clayton, Australia .
AD  - 2 Diabetes and Vascular Medicine Unit , Monash Health, Clayton, Australia .
FAU - Suen, Matthew
AU  - Suen M
AD  - 2 Diabetes and Vascular Medicine Unit , Monash Health, Clayton, Australia .
FAU - Pease, Anthony
AU  - Pease A
AD  - 2 Diabetes and Vascular Medicine Unit , Monash Health, Clayton, Australia .
FAU - Boyle, Jacqueline A
AU  - Boyle JA
AD  - 1 Monash Centre for Health Research and Implementation, School of Public Health 
      and Preventive Medicine, Monash University , Clayton, Australia .
AD  - 3 Monash Women's Services , Monash Health, Department of Obstetrics and 
      Gynecology, Clayton, Australia .
FAU - Soldatos, Georgia
AU  - Soldatos G
AD  - 1 Monash Centre for Health Research and Implementation, School of Public Health 
      and Preventive Medicine, Monash University , Clayton, Australia .
AD  - 2 Diabetes and Vascular Medicine Unit , Monash Health, Clayton, Australia .
FAU - Regan, John
AU  - Regan J
AD  - 3 Monash Women's Services , Monash Health, Department of Obstetrics and 
      Gynecology, Clayton, Australia .
FAU - Wallace, Euan M
AU  - Wallace EM
AD  - 3 Monash Women's Services , Monash Health, Department of Obstetrics and 
      Gynecology, Clayton, Australia .
AD  - 4 The Ritchie Centre, Department of Obstetrics and Gynaecology, Monash University 
      , Clayton, Australia .
FAU - Teede, Helena J
AU  - Teede HJ
AD  - 1 Monash Centre for Health Research and Implementation, School of Public Health 
      and Preventive Medicine, Monash University , Clayton, Australia .
AD  - 2 Diabetes and Vascular Medicine Unit , Monash Health, Clayton, Australia .
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20170310
PL  - United States
TA  - Diabetes Technol Ther
JT  - Diabetes technology & therapeutics
JID - 100889084
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
RN  - 0 (hemoglobin A1c protein, human)
SB  - IM
CIN - Diabetes Technol Ther. 2017 May;19(5):269-270. PMID: 28520530
MH  - Adult
MH  - Cohort Studies
MH  - Diabetes Mellitus, Type 1/blood/*drug therapy/physiopathology
MH  - Drug Administration Schedule
MH  - Female
MH  - Glycated Hemoglobin/analysis
MH  - Hospitals, University
MH  - Humans
MH  - Hyperglycemia/*prevention & control
MH  - Hypoglycemia/chemically induced/*prevention & control
MH  - Hypoglycemic Agents/*administration & dosage/adverse effects/therapeutic use
MH  - Infusions, Subcutaneous
MH  - Injections, Subcutaneous
MH  - Insulin/*administration & dosage/adverse effects/therapeutic use
MH  - *Insulin Infusion Systems/adverse effects
MH  - Patient Care Team
MH  - Pregnancy
MH  - Pregnancy Outcome
MH  - Pregnancy in Diabetics/blood/*drug therapy/physiopathology
MH  - Reproducibility of Results
MH  - Retrospective Studies
MH  - Victoria
OTO - NOTNLM
OT  - Continuous subcutaneous insulin infusion
OT  - HbA1c pregnancy
OT  - Insulin pump
OT  - Pregnancy outcome
OT  - Type 1 diabetes
EDAT- 2017/03/11 06:00
MHDA- 2018/03/13 06:00
CRDT- 2017/03/11 06:00
PHST- 2017/03/11 06:00 [pubmed]
PHST- 2018/03/13 06:00 [medline]
PHST- 2017/03/11 06:00 [entrez]
AID - 10.1089/dia.2016.0412 [doi]
PST - ppublish
SO  - Diabetes Technol Ther. 2017 May;19(5):280-287. doi: 10.1089/dia.2016.0412. Epub 
      2017 Mar 10.