Endocrine Abstracts

Introduction and objective: Treatment with integrated continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring systems (CGM) helps to improve glycaemic control in people with type 1 diabetes mellitus (DM1). There is increasing use in pregnant women, but there are no protocols for its continuation during delivery. The aim of this work is to analyse glycaemic control during pregnancy, in addition to studying obstetric and neonatal outcomes.

Methods: Descriptive study of 10 patients with DM1 treated with the Minimed 670G or 780G system during pregnancy and delivery at the AGS Sur in Seville.

Results: The mean maternal age was 37.2±3 years, 25.3±10 years since diagnosis, 70% of patients had diabetic retinopathy with no other associated diabetic complications. Weight gain during pregnancy was 12.2±4.7 kg. We present the glucometry parameters by trimester: 9 deliveries were term (8 without complications) and 1 preterm due to pre-eclampsia. 70% of the patients (3 caesarean sections) used intrapartum therapy with ISCI + MCG in automatic mode, with blood glucose levels in range without extra insulin, no postpartum hypoglycaemia was observed; 30% discontinued treatment (2 caesarean sections and 1 complicated delivery) with high blood glucose levels during and after delivery; one of them developed ketoacidosis in the immediate postpartum period. The weight of the NBs was 3377 +/- 599 g (2 macrosomic). Apgar > 7 in 90% of them, neonatal hypoglycaemia 30%, shoulder dystocia 20%, severe respiratory distress with admission to neonatal ICU 10%

Conclusion: Therapy with integrated CSII + CGM systems achieves good glycaemic control in pregnant women with type 1 DM. Maintaining this therapy during labour allowed good glycaemic control during delivery and prevented hypoglycaemia in the immediate postpartum period. Studies and protocols for the use of these treatments during labour and immediate postpartum are needed.