ECE2014 Poster Presentations Diabetes therapy (40 abstracts)
The effect of continuous subcutaneous insulin infusion therapy on acute complications and pregnancy outcome in pregnant women with type 1 diabetes mellitus
Nuri Cakir , Isilay Kalan , Alev Altinova , Cigdem Ozkan , Mujde Akturk , Ceyla Konca Degertekin , Ethem Turgay Cerit , Mehmet Muhittin Yalcin , Fusun Balos Toruner , Ayhan Karakoc , Ilhan Yetkin & Goksun Ayvaz
Endocrinology and Metabolism Department, Faculty of Medicine, Gazi University, Ankara, Turkey.
Background and aims: Fetal, maternal and perinatal complications are increased in pregnant women with type 1 diabetes mellitus (T1DM). In this study, we aimed to evaluate the effects of CSII on pregnancy outcomes, glycemic control and acute complications in pregnant women with T1DM.
Materials and methods: We retrospectively analyzed the data of women with T1DM, who were on CSII therapy during their pregnancy, followed at our clinic between 2008 and 2012. We examined 15 pregnant women with T1DM, five of whom were already on CSII therapy before pregnancy and ten patients who were swiched from MDI to CSII therapy at the beginning of their pregnancy due to frequent hypoglycemic and hyperglycemic attacks. Acute complications, fetal/maternal and perinatal complications and glicemic control were analyzed.
Results: The mean age of the patients was 28.2±3.6 years and the mean duration of diabetes was 8±5.4 years. Severe hypoglycemic episode and diabetic ketoacidosis were not observed during their pregnancy. The mean HbA1c at the beginning of pregnancy fell from 7.4±1.3 to 6.3±0.7% before delivery. The mean duration of pregnancy and neonatal birth weight were 37.1±1.2 weeks and 3537±794 g respectively. There were no stillbirths, perinatal infant deaths or congenital malformations. There were two preterm births due to preeclampsia, one of whom had a low birth weight (1800 g). One macrosomic baby with a birth weigt greater than 4500 g was recorded. Pre-pregnancy and before-delivery mean HbA1c values were not associated with neonatal birth weight or preterm delivery.
Conclusion: In our study, glycemic control improved with CSII therapy during pregnancy. However, despite a significant improvement in their HbA1c levels, the patients still had higher HbA1c than target values, which could be explained by selection of a population with hard-to-control glycemia. Severe hypoglycemia or diabetic ketoacidosis were not detected in our study. We conclude that in pregnant women with T1DM of whom glycemic control could not be achieved with MDI therapy, CSII therapy is a safe and appropriate treatment regimen to provide well glycemic control.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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