Diabetes control and pregnancy outcomes in women with type 1 diabetes treated during pregnancy with continuous subcutaneous insulin infusion or multiple daily insulin injections

Objectives. The aim of the study was to compare diabetes control and obstetrical outcomes in pregnant women with type 1 diabetes treated during pregnancy with either continuous subcutaneous insulin infusion (CSII) or multiple daily insulin injections (MDII). Patients and methods. It was a descriptive, retrospective, observational study of 116 Caucasian pregnant women with type 1 diabetes mellitus. Thirty women were treated during pregnancy with continuous subcutaneous insulin infusion (CSII group) and 86 with multiple daily insulin injections (MDII group). Results. Mean age and body mass index did not differ between groups (p >0.05). Duration of diabetes was longer in CSII than in MDII group, 12.7 ±7.20 vs. 7.71 ±6.13 years, respectively (p = 0.0005). There were no differences between the studied groups in glycated hemoglobin (HbA1c) levels in the I, II and III trimesters of pregnancy – in CSII group 7.41 ±1.75, 6.57 ±1.09 and 6.46 ±0.87, respectively, in MDII group – 7.71 ±2.37, 6.65 ±1.18 and 6.75 ±1.21, respectively (p >0.05). There were no severe hypoglycemia and diabetic coma. Mean duration of pregnancy, rate of premature deliveries, newborn birth weight, incidence of SGA and LGA, and the frequency of neonatal hypoglycemia did not differ between groups (p >0.05). The total malformation rate was 5.13%, including 2 terminated pregnancies and the frequency did not differ between groups (p >0.05). The rate of spontaneous abortions was 16.7% in CSII group and 10.3% in MDII (p >0.05). Conclusions. No apparent relationships between mode of insulin therapy and pregnancy outcome were found in type 1 diabetes patients.