Glycemic control and perinatal outcomes of pregnancies complicated by type 1 diabetes: influence of continuous subcutaneous insulin infusion and lispro insulin
| العنوان: | Glycemic control and perinatal outcomes of pregnancies complicated by type 1 diabetes: influence of continuous subcutaneous insulin infusion and lispro insulin |
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| المؤلفون: | Apolonia García-Patterson, Rosa Corcoy, M Dolores Santos, Ignasi Saigi, Juan M. Adelantado, Gemma Ginovart, Ana Chico, Alberto de Leiva |
| المصدر: | Diabetes Technology & Therapeutics r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau instname |
| سنة النشر: | 2010 |
| مصطلحات موضوعية: | Adult, Blood Glucose, medicine.medical_specialty, Diabetic ketoacidosis, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Pregnancy in Diabetics, Cohort Studies, chemistry.chemical_compound, Endocrinology, Insulin Infusion Systems, Pregnancy, Internal medicine, Diabetes mellitus, medicine, Insulin lispro, Humans, Hypoglycemic Agents, Insulin, Glycemic, Glycated Hemoglobin, Type 1 diabetes, Insulin Lispro, business.industry, Obstetrics, Infant, Newborn, Pregnancy Outcome, Infusion Pumps, Implantable, medicine.disease, Hypoglycemia, Medical Laboratory Technology, Diabetes Mellitus, Type 1, chemistry, Regression Analysis, Female, Glycated hemoglobin, business, medicine.drug |
| الوصف: | Aims: This study compared glycemic control and maternal and fetal outcomes in pregnant women with type 1 diabetes mellitus (T1DM) treated with multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII) using regular (RI) or lispro (LP) insulin. Methods: Three hundred fifteen consecutive singleton pregnancies of T1DM women using the same insulin program since before pregnancy (196 MDI with NPH + RI, 16 MDI with NPH + LP, 44 CSII with RI, 59 CSII with LP) were studied. Variables of glycemic control assessed included glycated hemoglobin, mean blood glucose (MBG), and insulin doses in each trimester, diabetic ketoacidosis, and hypoglycemic comas. Variables of pregnancy outcome included miscarriage, preterm birth, large or small for gestational age (LGA or SGA, respectively) newborns, and perinatal mortality. Multiple linear regression and logistic regression analysis were used. Results: Groups differed in baseline and glycemic control but not in maternal or fetal outcomes. In multivariate analysis, LP was associated with higher second trimester MBG and lower rate of hypoglycemic coma, CSII with higher third trimester MBG, and CSII + LP with lower insulin requirements and lower rate of hypoglycemic coma. As to pregnancy outcomes, LP was associated with lower risk of preterm birth and higher risk of SGA, CSII with lower risk of SGA and higher risk of LGA and perinatal mortality, and CSII + LP with higher risk of miscarriage. Conclusions: Pregnant women with T1DM using LP and/or CSII had different characteristics. LP with or without CSII was independently associated with fewer hypoglycemic comas, whereas impact of LP/CSII on the fetus had a favorable or an unfavorable influence depending on the specific outcome. |
| تدمد: | 1557-8593 1520-9156 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::15080ec8ac367a5fb4247079ad5bad03Test https://pubmed.ncbi.nlm.nih.gov/21128840Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....15080ec8ac367a5fb4247079ad5bad03 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15578593 15209156 |
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