Maternal–Fetal Outcomes in 34 Pregnant Women with Type 1 Diabetes in Sensor-Augmented Insulin Pump Therapy
Mostra/ Apri
Data
2017-02-06Autore
Gómez, Ana MaríaMarín Carrillo, Lisseth Fernanda
Arévalo Correa, Carol M.
Muñoz Velandia, Oscar Mauricio
Rondón Sepúlveda, Martín Alonso
Silva Herrera, Jaime Luis
Henao Carrillo, Diana Cristina
Autore/i aziendale
Pontificia Universidad Javeriana. Facultad de Medicina. Departamento de Epidemiología Clínica y Bioestadística
Pontificia Universidad Javeriana. Facultad de Medicina. Departamento de Medicina Interna. Enfermedades Crónicas del Adulto
Tipo
Artículo de revista
ISSN
1520-9156 - 1557-8593 (Eléctronico)
Pagine
417-422
Tipo di oggetto
Artículo original
Condividi questo record
Citación
Metadata
Mostra tutti i dati dell'item
Documenti PDF
Titolo inglese
Maternal–Fetal Outcomes in 34 Pregnant Women with Type 1 Diabetes in Sensor-Augmented Insulin Pump TherapyAstratto
Background: Pregnancy in women with type 1 diabetes (T1D) is associated with increased risk of maternal complications and neonatal morbidity and mortality. Optimizing glycemic control improves these
outcomes.
Objective: To describe the experience of using sensor-augmented insulin pump therapy (SAPT) and SAPT +
low-glucose suspension (LGS) on pregnant women with T1D, including neonatal and maternal outcomes.
Methods: A prospective observational study was conducted in women with T1D who started SAPT and SAPT +
LGS before or during pregnancy at the San Ignacio University Hospital Diabetes Center in Bogota´, Colombia.
The main indication was severe hypoglycemia (SH) and poor glycemic control. Glycated hemoglobin (A1c),
hypoglycemia, and maternal and fetal outcomes were assessed.
Results: Thirty-four pregnant women with T1D on SAPT and SAPT + LGS were included. Sixteen patients started
therapy during pregnancy at a mean gestational age of 17.6 – 8.3 weeks. Mean preconceptional A1c was
8.24% – 2.02%. Absolute reduction of A1c level from prepregnancy to third trimester was -1.63% (P< 0.0001), with
a significant clinical and statistical reduction in both groups, women who initiated SAPT before or during pregnancy.
52.9% of patients in second trimester and 66.6% in third trimester achieved A1c <6.5%, respectively. 91.1%
underwent cesarean section. The main reasons were iterative cesarean (30%), fetal distress (20%), and preeclampsia
(16%). The median gestational age at delivery was 37 weeks and 15 pregnancies resulted in preterm delivery. There
was neither maternal–fetal mortality nor severe hypoglycemic episodes. Two patients had diabetic ketoacidosis.
Conclusions: In pregnant patients with T1D and high risk of hypoglycemia, SAPT and SAPT + LGS should be
considered as a therapeutic alternative for A1c reduction with a low risk of SH. However, additional studies are
required to evaluate the efficacy and safety of this therapy during pregnancy.
Keywords
Sensor-augmented pump therapyLow-glucose suspension
Continuous glucose monitoring
Pregnancy
Type 1 diabetes mellitus
Severe hypoglycemia and maternal–fetal outcomes
Link alla risorsa
https://www.liebertpub.com/toc/dia/19/7Editoriale
Diabetes Technology & Therapeutics; Vol. 19 Núm. 7 (2017)
Google Analytics Statistics