Insulin pump therapy with and without continuous glucose monitoring in pregnant women with type 1 diabetes: a prospective observational Orchestra Foundation study in Poland

被引：4

作者：

Cypryk, Katarzyna ^{[1
]}

Wender-Ozegowska, Ewa ^{[2
]}

Cyganek, Katarzyna ^{[3
,4
]}

Sieradzki, Jacek ^{[4
]}

Skoczylas, Kinga ^{[5
]}

Chen, Xiaoxiao ^{[6
]}

Cordero, Toni L. L. ^{[6
]}

Shin, John ^{[6
]}

Cohen, Ohad ^{[7
]}

机构：

[1] Med Univ Lodz, Dept Internal Dis & Diabetol, Pomorska Str 251, PL-92213 Lodz, Poland

[2] Poznan Univ Med Sci, Dept Reprod, Poznan, Poland

[3] Univ Hosp Krakow, Dept Metab Dis, Krakow, Poland

[4] Jagiellonian Univ Krakow, Coll Med, Krakow, Poland

[5] Medtronic, Warsaw, Poland

[6] Medtronic, Northridge, CA USA

[7] Medtronic, Tolochenaz, Switzerland

来源：

ACTA DIABETOLOGICA | 2023年 / 60卷 / 04期

关键词：

Type 1 diabetes-complicated pregnancy; HbA1c; Continuous subcutaneous insulin infusion (CSII); Continuous glucose monitoring (CGM); Large for gestational age (LGA); Neonatal outcomes; GLYCEMIC CONTROL; SEVERE HYPOGLYCEMIA; OUTCOMES; INFUSION; RISK; MELLITUS; IMPLEMENTATION; KETOACIDOSIS; PREECLAMPSIA; ASSOCIATION;

D O I：

10.1007/s00592-022-02020-9

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

AimsThe effects of continuous subcutaneous insulin infusion (CSII) therapy with or without continuous glucose monitoring (CGM) on neonatal outcomes and glycemic outcomes of pregnant women with type 1 diabetes (T1D), living in Poland, were assessed.MethodsThis prospective observational study enrolled women with T1D (N = 481, aged 18-45 years) who were pregnant or planned pregnancy. All used CSII therapy and a subset used CGM with CSII (CSII + CGM). Neonatal outcomes (e.g., rate of large for gestational age [LGA] delivery [birth weight > 90th percentile]) and maternal glycemia (e.g., HbA1c and percentage of time at sensor glucose ranges) were evaluated.ResultsOverall HbA1c at trimesters 1, 2, and 3 was 6.8 +/- 1.1% (50.9 +/- 12.3 mmol/mol, N = 354), 5.8 +/- 0.7% (40.1 +/- 8.0 mmol/mol, N = 318), and 5.9 +/- 0.7% (41.4 +/- 8.0 mmol/mol, N = 255), respectively. A HbA1c target of < 6.0% (42 mmol/mol) at each trimester was achieved by 20.9% (74/354), 65.1% (207/318), and 58.0% (148/255), respectively. For women using CSII + CGM versus CSII only, HbA1c levels at trimesters 1, 2, and 3 were 6.5 +/- 0.9% versus 7.1 +/- 1.3% (47.8 +/- 9.7 mmol/mol versus 54.3 +/- 14.0 mmol/mol, p < 0.0001), 5.7 +/- 0.6% versus 6.0 +/- 0.9% (38.9 +/- 6.5 mmol/mol versus 41.6 +/- 9.3 mmol/mol, p = 0.0122), and 5.8 +/- 0.6% versus 6.1 +/- 0.8% (40.3 +/- 6.9 mmol/mol versus 42.9 +/- 9.1 mmol/mol, p = 0.0117), respectively. For the overall, CSII only, and CSII + CGM groups, rates of LGA delivery were 22.7% (74/326), 24.6% (34/138), and 21.3% (40/188), respectively.ConclusionsObservational assessment of women with T1D using CSII therapy demonstrated low HbA1c throughout pregnancy and low rates of LGA. The addition of CGM to CSII therapy compared to CSII therapy alone was associated with some improved maternal glycemic and neonatal outcomes.Clinicaltrials.gov identifierNCT01779141 (January 2013).

引用

页码：553 / 561

页数：9

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