Glycemic control and maternal and fetal outcomes in pregnant women with type 1 diabetes according to the type of basal insulin

被引：16

作者：

Chico, A. ^{[1
,2
,3
]}

Herranz, L. ^{[4
]}

Corcoy, R. ^{[1
,2
,3
]}

Ramirez, O. ^{[5
]}

Goya, M. M. ^{[6
]}

Bellart, J. ^{[7
]}

Gonzalez-Romero, S. ^{[8
]}

Codina, M. ^{[9
]}

Sanchez, P. ^{[10
]}

Cortazar, A. ^{[11
,12
]}

Acosta, D. ^{[13
]}

Picon, M. J. ^{[14
]}

Rubio, J. A. ^{[15
]}

Megia, A. ^{[12
,16
,17
,18
]}

Sancho, M. A. ^{[19
]}

Balsells, M. ^{[20
]}

Sola, E. ^{[21
]}

Gonzalez, N. L. ^{[22
]}

Lopez-Lopez, J. ^{[23
]}

机构：

[1] Hosp Santa Creu & Sant Pau, Dept Endocrinol, Av St Antoni Maria Claret 167, Barcelona 08025, Spain

[2] CIBER BBN, Barcelona, Spain

[3] Univ Autonoma Barcelona, Dept Med, Av St Antoni Maria Claret 167, Barcelona 08025, Spain

[4] Hosp La Paz, Dept Endocrinol, Castellana 261, Madrid 28046, Spain

[5] Hosp Materno Infantil Canarias, Dept Obstet & Gynecol, Av Maritima Sur S-N, Las Palmas Gran Canaria 35001, Las Palmas, Spain

[6] Hosp Vail Hebron, Dept Obstet, Passeig Vail Hebron 119-129, Barcelona 08035, Spain

[7] Hosp Clin Barcelona, Dept Obstet & Gynecol, Sabino Arana 1, Barcelona 08028, Spain

[8] Hosp Reg Malaga, Dept Endocrinol, Av Carlos Haya S-N, Malaga 29010, Spain

[9] Hosp Son Espases, Dept Endocrinol, Carretera Valldemossa 79, Palma De Mallorca 07120, Illes Balears, Spain

[10] Hosp Gregorio Maranon, Dept Endocrinol, Calle Dr Esquerdo 46, Madrid 28007, Spain

[11] Hosp Cruces, Dept Endocrinol, Plaza Cruces 12, Baracaldo 48903, Vizcaya, Spain

[12] CIBERDEM, Barcelona, Spain

[13] Hosp Virgen Rocio, Dept Endocrinol, Av Manuel Siurot S-N, Seville 41013, Spain

[14] Hosp Virgen Victoria, Dept Endocrinol, Campus Teatinos S-N, Malaga 29010, Spain

[15] Hosp Principe Asturias, Dept Endocrinol, Carretera Alcala Meco S-N, Madrid 28805, Spain

[16] Hosp Univ Tarragona Joan XXIII, Dept Endocrinol, C Dr Mallafre Guasch 4, Tarragona 43005, Spain

[17] IISPV, Madrid, Spain

[18] Univ Rovira & Virgili, C Dr Mallafre Guasch 4, Tarragona 43005, Spain

[19] Hosp Clin Lozano Blesa, Dept Endocrinol, Ave San Juan Bosco 15, Zaragoza 50009, Spain

[20] Hosp Mutua Terrassa, Dept Endocrinol, Placa Doctor Robert 5, Barcelona 08221, Spain

[21] Hosp Dr Peset, Dept Endocrinol, Gaspar Aguilar 90, Valencia 46017, Spain

[22] Hosp Clin, Dept Obstet & Gynecol, Ctra Ofra S-N, Tenerife 38320, Spain

[23] Hosp Virgen Salud, Dept Endocrinol, Ave Barber 30, Toledo 45071, Spain

来源：

EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY | 2016年 / 206卷

关键词：

Insulin analogue; Continuous subcutaneous insulin infusion; Glycated haemoglobin; Perinatal outcomes; Type; 1; diabetes; Pregnancy; CONTINUOUS SUBCUTANEOUS INSULIN; MULTIPLE DAILY INJECTIONS; PERINATAL OUTCOMES; RANDOMIZED-TRIAL; INFUSION; RECOMMENDATIONS; GLARGINE; ANALOGS;

D O I：

10.1016/j.ejogrb.2016.07.490

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

Objective: To examine the potential role of the type of basal insulin on glycemic control and maternal and foetal outcomes in pregnant women with type 1 diabetes (T1DM). Study design: Retrospective cohort study of pregnancies attended at 18 Spanish tertiary hospitals. Inclusion criteria: T1DM, singleton pregnancies, delivery between 2002-2010, and use of the same basal and prandial insulin from before pregnancy until delivery. Results: A total of 1534 pregnancies were included. The basal insulin most commonly used was Neutral Protamine Hagedorn (NPH) (51.7%), followed by glargine (23.2%) and continuous subcutaneous insulin infusion (CSII) (21.1%). CSII users had longer diabetes duration. Multiple logistic regression analysis showed that CSII was independently associated with lower doses of insulin, higher glycated haemoglobin (HbA(1c)) in all trimesters, and higher rates of miscarriage, preterm birth and neonatal hypoglycemia. Glargine was related to a higher risk of preterm birth and a small-for-gestational age infant (SGA). The odds ratios (OR) of the associations between insulin type and clinical outcomes (from 0.642 to 4.894) have a relevant magnitude. Conclusions: In this observational study of pregnant women with T1DM, the type of basal insulin was independently associated with metabolic variables and foetal outcomes. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

引用

页码：84 / 91

页数：8

共 25 条

[1] Confidence intervals: something more than a statistical significance test [J].

Argimon, JM .

MEDICINA CLINICA, 2002, 118 (10) :382-384

[2] Type 1 diabetes control and pregnancy outcomes in women treated with continuous subcutaneous insulin infusion (CSII) or with insulin glargine and multiple daily injections of rapid-acting insulin analogues (glargine-MDI) [J].

Bruttomesso, D. ;

Bonomo, M. ;

Costa, S. ;

Dal Pos, M. ;

Di Cianni, G. ;

Pellicano, F. ;

Vitacolonna, E. ;

Dodesini, A. R. ;

Tonutti, L. ;

Lapolla, A. ;

Di Benedetto, A. ;

Torlone, E. .

DIABETES & METABOLISM, 2011, 37 (05) :426-431

[3]

Carrascosa A., 2008, ENDOCRINOL NUTR, V55, P484, DOI [DOI 10.1016/S1575-0922(08)75845-5, 10.1016/S1575-0922(08)75845-5]

[4]

Chen R, 2002, AM J OBSTET GYNECOL, V4, pe1

[5]

Chico Ana, 2014, J Diabetes Sci Technol, V8, P371

[6] Glycemic Control and Perinatal Outcomes of Pregnancies Complicated by Type 1 Diabetes: Influence of Continuous Subcutaneous Insulin Infusion and Lispro Insulin [J].

Chico, Ana ;

Saigi, Ignasi ;

Garcia-Patterson, Apolonia ;

Dolores Santos, M. ;

Adelantado, Juan M. ;

Ginovart, Gemma ;

de Leiva, Alberto ;

Corcoy, Rosa .

DIABETES TECHNOLOGY & THERAPEUTICS, 2010, 12 (12) :937-945

[7] Perinatal Outcomes in Pregnancies Managed with Antenatal Insulin Glargine [J].

Egerman, Robert S. ;

Ramsey, Risa D. ;

Kao, Lu W. ;

Bringman, Jay J. ;

Haerian, Haleh ;

Kao, Jerome L. ;

Bush, Andrew J. .

AMERICAN JOURNAL OF PERINATOLOGY, 2009, 26 (08) :591-595

[8] Use of insulin lispro during pregnancy in women with pregestational diabetes mellitus [J].

Garcia-Dominguez, Maria ;

Herranz, Lucrecia ;

Hillman, Natalia ;

Martin-Vaquero, Pilar ;

Janez, Mercedes ;

Moya-Chimenti, Elisa ;

Pallardo, Luis Felipe .

MEDICINA CLINICA, 2011, 137 (13) :581-586

[9] RAPID-ACTING INSULIN ANALOGUES IN BASAL-BOLUS REGIMENS IN TYPE 1 DIABETES MELLITUS [J].

Garg, Satish ;

Javier Ampudia-Blasco, Francisco ;

Pfohl, Martin .

ENDOCRINE PRACTICE, 2010, 16 (03) :486-505

[10] Continuous Subcutaneous Insulin Infusion Versus Multiple Daily Injections in Pregnant Women with Type 1 Diabetes [J].

Gonzalez-Romero, Stella ;

Gonzalez-Molero, Inmaculada ;

Fernandez-Abellan, Micaela ;

Dominguez-Lopez, Marta E. ;

Ruiz-de-Adana, Soledad ;

Olveira, Gabriel ;

Soriguer, Federico .

DIABETES TECHNOLOGY & THERAPEUTICS, 2010, 12 (04) :263-269

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