and 3 other(s)
Background: Excellent glycemic control before and during pregnancy complicated by type 1 diabetes (T1DM) are important to limit number of poor obstetric and neonatal outcomes. The aim of the study was to assessed pregnancy outcome of pregnant T1DM women treated three different methods: sensor augmented pump (SAP), pumps with predictive low-glucose insulin suspend (640G) or multiple daily insulin injection (MDI). Materials and Methods: We analyzed medical records of 81 pregnant T1DM women, treated: SAP therapy (n=56), 640G (n=14) or MDI (n=11). CGM were used by 13/14 (93%) women 640G group, 15/56(27%) SAP group and 0/11(0%) MDI group. We analyzed of glycemic control as assessed by the HbA1c level, pregnancy outcomes. Results: The statistically lower level of HbA1c was observed in 640G group as compare with SAP and MDI group, before pregnancy (6.0% vs 6.5% (p=0.31) vs 6.9% (p=0.089), respectively, at the 1st trimester (5.7% vs 6.1% (p=0.39) vs 6.8% (p=0.0007); during 2nd (5.1% vs 5.6% (p=0.042) vs 5.7% (p=0.0025); 3rd trimester (5.2% vs 5.7% (p=0.022) vs 6.1% (p=0.0038). We observed higher frequency of macrosomia in MDI group (respectively 640G 14%, SAP 26% and MDI 37%; p=0.77). In 640G group we found statistically lower frequency of composite pregnancy outcome (macrosomia, SGA, fetal malformations, end of pregnancy before 37 weeks) as compared with SAP and MDI, respectively: 21% vs 50% vs 64%; p=0.07. Conclusions: The observation shows the effectiveness of the predictive low-glucose suspend (640G) insulin pump during pregnancy in diabetic women in achieving the glycemic target and improvement of pregnancy outcomes.
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