Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Dec;14(12):1383-1390.
doi: 10.1111/jdi.14075. Epub 2023 Sep 14.

Advantages of sensor-augmented insulin pump therapy for pregnant women with type 1 diabetes mellitus

Hitomi Imafuku  1 , Kenji Tanimura  1 , Naohisa Masuko  1 , Masako Tomimoto  1 , Yutoku Shi  1 , Akiko Uchida  1 , Masashi Deguchi  1 , Kazumichi Fujioka  2 , Akane Yamamoto  3 , Kei Yoshino  3 , Yushi Hirota  3 , Wataru Ogawa  3 , Yoshito Terai  1
Affiliations

Advantages of sensor-augmented insulin pump therapy for pregnant women with type 1 diabetes mellitus

Hitomi Imafuku et al. J Diabetes Investig. 2023 Dec.

Abstract

Aims/introduction: To evaluate the efficacy of sensor-augmented pump (SAP) for improving obstetric and neonatal outcomes among pregnant women with type 1 diabetes mellitus by comparing it with continuous subcutaneous insulin infusion plus self-monitoring of blood glucose (continuous subcutaneous insulin infusion [CSII]/SMBG).

Materials and methods: This retrospective cohort study included 40 cases of pregnancy complicated by type 1 diabetes mellitus treated with SAP (SAP group), and 29 cases of pregnancy complicated by type 1 diabetes mellitus treated with CSII/SMBG (CSII/SMBG group). The obstetric and neonatal outcomes were compared between the two groups.

Results: The median of the glycoalbumin levels in the first (18.8% vs 20.9%; P < 0.05) and second (15.4% vs 18.0%; P < 0.05) trimesters, the hemoglobin A1c levels in the peripartum period (6.1% vs 6.5%; P < 0.05) and the standard deviation score of birthweights (0.36 vs 1.52; P < 0.05) were significantly lower in the SAP group than in the CSII/SMBG group. The incidence rate of large for gestational age newborns was significantly lower in the SAP group than in the CSII/SMBG group (27.5% vs 65.5%; P < 0.05). No significant differences in the incidence rates of hypertensive disorders of pregnancy, small for gestational age, respiratory distress syndrome, neonatal hypoglycemia, hypervolemia and hyperbilirubinemia were observed between the groups.

Conclusion: The present study showed that SAP therapy is more effective in preventing large for gestational age newborns in pregnant women with type 1 diabetes mellitus than CSII/SMBG.

Keywords: Pregnant women; Sensor-augmented pump; Type 1 diabetes mellitus.

PubMed Disclaimer

Figures

Figure 1
Figure 1
A flow diagram of the study population. CSII, continuous subcutaneous insulin infusion; DM, diabetes mellitus; GW, gestational weeks; isCGM, intermittently scanned continuous glucose monitoring; MDI, multiple daily injections; SAP, sensor‐augmented insulin pump; SMBG, self‐monitoring of blood glucose.
Figure 2
Figure 2
(a) The total daily insulin dose in the first and second trimesters, and the peripartum period in the sensor‐augmented insulin pump therapy group, and (b) continuous subcutaneous insulin infusion plus self‐monitoring of the blood glucose group. Statistical significance was calculated using the Mann–Whitney U‐test with a Bonferroni correction.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Persson M, Norman M, Hanson U. Obstetric and perinatal outcomes in type 1 diabetic pregnancies: a large, population‐based study. Diabetes Care 2009; 32: 2005–2009. - PMC - PubMed
    1. Holmes VA, Young IS, Patterson CC, et al. Optimal glycemic control, pre‐eclampsia, and gestational hypertension in women with type 1 diabetes in the diabetes and pre‐eclampsia intervention trial. Diabetes Care 2011; 34: 1683–1688. - PMC - PubMed
    1. Maresh MJ, Holmes VA, Patterson CC, et al. Glycemic targets in the second and third trimester of pregnancy for women with type 1 diabetes. Diabetes Care 2015; 38: 34–42. - PubMed
    1. Feig DS, Corcoy R, Donovan LE, et al. Pumps or multiple daily injections in pregnancy involving type 1 diabetes: a prespecified analysis of the CONCEPTT randomized trial. Diabetes Care 2018; 41: 2471–2479. - PubMed
    1. Feig DS, Donovan LE, Corcoy R, et al. Continuous glucose monitoring in pregnant women with type 1 diabetes (CONCEPTT): a multicentre international randomised controlled trial. Lancet (London, England) 2017; 390: 2347–2359. - PMC - PubMed