Acute Complications and Pregnancy Outcomes with Continuous Subcutaneous Insulin Infusion Therapy in Pregnant Women with Type 1 Diabetes Mellitus

ABSTRACT

Objective: Pregnant women with type 1 diabetes mellitus (T1DM) have increased risk of fetal, maternal, and perinatal complications. In this report, we aimed to evaluate the effects of continuous subcutaneous insulin infusion (CSII) therapy on pregnancy outcomes, glycemic control, and acute complications in pregnant women with T1DM. Material and Methods: We retrospectively analyzed the data of 15 women with T1DM who were on CSII therapy during their pregnancy, and who were followed up at our clinic between 2008 and 2014. Acute complications, fetal/maternal, and perinatal complications, and glycemic 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. We did not observe severe hypoglycemic episodes and diabetic ketoacidosis during their pregnancy. The mean HbA1c levels at 4-8 weeks of pregnancy decreased from 7.4±1.3% to 6.3±0.7% at 34-38 weeks of pregnancy. The mean duration of pregnancy and neonatal birth weight were 37.1±1.2 weeks and 3.537±794 g, respectively. There were no stillbirths, perinatal infant deaths, or congenital malformations noted. There were two preterm births due to preeclampsia, one of whom had a low birth weight (1.800 g). We recorded one macrosomic baby (4.730 g). Conclusion: We observed that glycemic control improved with CSII therapy during pregnancy. We did not detect severe hypoglycemia or diabetic ketoacidosis in our research. In pregnant women with T1DM who had inadequate glycemic control with multiple daily insulin injection therapy, CSII might be a safe and appropriate treatment regimen.