Endocrine Abstracts

Introduction: Pregestational diabetes is a threatening condition for pregnancy; a strict glycemic control can decrease some pregnancy complications. That control can be achieved while on multiple daily insulin injections (MDI) treatment or with subcutaneous insulin infusion systems (CSII). Up to now no benefits of CSII treatment over MDI on pregnancy outcomes have been proved.

Design: Case control retrospective study, comparing glycemic control and pregnancy outcomes between type 1 diabetic pregnancies CSII or MDI treated (1996–2010). Selected variables were compared with X2 or Student-T or Mann-Withney tests. A P<0.05 was considered significant.

Results: Women treated with MDI were older; to get comparable groups, we excluded some women (disease for <7 years), then obtaining 206 pregnancies (138 women): 50 pregnancies treated with CSII and 156 with MDI. Age, duration of diabetes, retinopathy and nephropathy were not significantly different. Insulin pumps were mostly installed while on pregnancy planning; thus, planned pregnancies were much more common in the CSII group (84% vs 40.4%, p <0.000). Preconception HbA1c was significantly lower for CSII group (6.78±0.68 vs 7.32±1.36, p 0.015); for the 1st and 2nd terms no differencies were found, and for the 3rd term HbA1c was even better for MDI group (6.50±0.64 vs 6.16±0.74, p 0.015). Severe hypoglycemic events and ketoacidosis, miscarriages, gestational hypertension, preterm birth, cesarean sections, congenital anomalies, big babies, respiratory distress, hypoglycemia or jaundice did not show significant differences between groups, either.

Conclusions: As other authors, we were not able to show that CSII treatment improved metabolic control or pregnancy outcomes.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.