Maternal and perinatal outcomes in pregnant women with type 1 diabetes treated with continuous subcutaneous insulin infusion and real time continuous glucose monitoring in two specialized centers in Medellin, Colombia

• Published in: The journal of maternal-fetal & neonatal medicine 2018-03, Vol.31 (6), p.696-700
• Main Authors: Restrepo-Moreno, Mónica, Ramírez-Rincón, Alex, Hincapié-García, Jaime, Palacio, Andrés, Monsalve-Arango, Claudia, Aristizabal-Henao, Natalia, Restrepo-Zapata, Camila, Botero-Arango, José Fernando
• Format: Article
• Language: English
• Subjects: Adult; Blood Glucose - metabolism; Blood Glucose Self-Monitoring - methods; Cesarean Section; Colombia; continuous insulin infusion system; Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - drug therapy; Female; Fetal Macrosomia - etiology; Gestational Age; Glycated Hemoglobin A - analysis; Humans; Hyperglycemia - blood; Hyperglycemia - etiology; Hypoglycemic Agents - administration & dosage; Infusion Pumps, Implantable; Infusions, Subcutaneous; Insulin - administration & dosage; Insulin Infusion Systems; Pregnancy; Retrospective Studies; Type 1 diabetes
• ISSN: 1476-7058; 1476-4954
• DOI: 10.1080/14767058.2017.1295952

Objective: We assessed maternal and perinatal outcomes in pregnant women with type 1 diabetes, treated with continuous subcutaneous insulin infusion and real time continuous glucose monitoring. Methods: This is a retrospective study, analyzing the basal characteristics, glycemic control, maternal and perinatal outcomes of pregnant women with type 1 diabetes, who were on an insulin pump with continuous glucose monitoring between 2011 and 2015. Results: Fourteen patients were included. The median age was 33 and disease duration 12 years. Indications for therapy were mainly poor glycemic control and severe hypoglycemia. The median A1c decrease was 1.02% between the first and third trimester. Pregnancies were associated with complications: 7.1% of the patients had diabetic ketoacidosis, 7.1% had an abortion, 28.5% gestational hypertension and 12.2% preeclampsia. The median gestational age at birth was 37 weeks and four days; the frequency of preterm birth was 7.1% and macrosomia 21.4%. There were no congenital malformations or perinatal death. Conclusions: Baseline characteristics and results of patients in this study were similar to those reported in the previous literature. Continuous subcutaneous insulin infusion with continuous glucose monitoring is an alternative treatment option for pregnant women with type 1 diabetes before or during pregnancy.