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Maternal–Fetal Outcomes in 34 Pregnant Women with Type 1 Diabetes in Sensor-Augmented Insulin Pump Therapy

dc.contributor.authorGómez, Ana María
dc.contributor.authorMarín Carrillo, Lisseth Fernanda
dc.contributor.authorArévalo Correa, Carol M.
dc.contributor.authorMuñoz Velandia, Oscar Mauricio
dc.contributor.authorRondón Sepúlveda, Martín Alonso
dc.contributor.authorSilva Herrera, Jaime Luis
dc.contributor.authorHenao Carrillo, Diana Cristina
dc.contributor.corporatenamePontificia Universidad Javeriana. Facultad de Medicina. Departamento de Epidemiología Clínica y Bioestadística
dc.contributor.corporatenamePontificia Universidad Javeriana. Facultad de Medicina. Departamento de Medicina Interna. Enfermedades Crónicas del Adulto
dc.date.accessioned2020-04-03T21:05:07Z
dc.date.accessioned2020-04-15T13:26:35Z
dc.date.available2020-04-03T21:05:07Z
dc.date.available2020-04-15T13:26:35Z
dc.date.created2017-02-06
dc.description.abstractenglishBackground: 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.spa
dc.description.paginas417-422spa
dc.description.tipoarticuloArtículo originalspa
dc.formatPDFspa
dc.format.mimetypeapplication/pdfspa
dc.format.soportePapel / Electrónicospa
dc.identifierhttps://www.liebertpub.com/toc/dia/19/7spa
dc.identifier.doihttps://doi.org/10.1089/dia.2017.0030spa
dc.identifier.issn1520-9156 - 1557-8593 (Eléctronico)spa
dc.identifier.urihttp://hdl.handle.net/10554/48072
dc.languagespaspa
dc.rights.licenceAtribución-NoComercial 4.0 Internacional*
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/*
dc.sourceDiabetes Technology & Therapeutics; Vol. 19 Núm. 7 (2017)spa
dc.subject.keywordSensor-augmented pump therapyspa
dc.subject.keywordLow-glucose suspensionspa
dc.subject.keywordContinuous glucose monitoringspa
dc.subject.keywordPregnancyspa
dc.subject.keywordType 1 diabetes mellitusspa
dc.subject.keywordSevere hypoglycemia and maternal–fetal outcomesspa
dc.titleMaternal–Fetal Outcomes in 34 Pregnant Women with Type 1 Diabetes in Sensor-Augmented Insulin Pump Therapyspa
dc.title.englishMaternal–Fetal Outcomes in 34 Pregnant Women with Type 1 Diabetes in Sensor-Augmented Insulin Pump Therapyspa
dc.typeinfo:eu-repo/semantics/article
dc.type.hasversionhttp://purl.org/coar/version/c_ab4af688f83e57aa
dc.type.localArtículo de revistaspa

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