Analysis of continuous patient data from the Czech National Register of patients with type 1 and type 2 diabetes using insulin pump therapy

Pre-Gestational Diabetes and Pregnancy Outcomes

“…It is established that diabetes mellitus care during the pre-pregnancy period is one of the most important factors leading to better glycaemic control and favourable obstetrical outcomes in pregnant women with diabetes mellitus [7].Improvement in glycaemic control during pregnancy decreased the risk of LGA infants [18][19][20], preterm delivery [21] and preeclampsia [22] in previous studies. We found reported in a number of previous studies [23][24][25][26][27]; the opposite finding was seen in one recent trial using continuous glucose monitoring [28]. In one study, SCII patients had higher rates of miscarriage and emergency CS and a marginally raised rate of IUFD and congenital anomalies; their babies were heavier and had a higher rate of LGA.…”

Continuous subcutaneous insulin infusion vs multiple daily injections in pregnant women with type 1 diabetes mellitus: a systematic review and meta-analysis of randomised controlled trials and observational studies

“…In the third trimester, the difference was not significant, at a magnitude of less than 0.1%, without clinical relevance. A number of RCTs and several meta-analyses, as well as observational studies, have previously shown that CSII results in better glycaemic control than MDI in the general T1DM population (12,67,68,69,70). It is likely that the differences favouring CSII in the current report, particularly in the first trimester, reflect the fact that women on insulin pumps had lower glucose levels already outside of pregnancy in the preconception period (69,70).…”

“…A number of RCTs and several meta-analyses, as well as observational studies, have previously shown that CSII results in better glycaemic control than MDI in the general T1DM population (12,67,68,69,70). It is likely that the differences favouring CSII in the current report, particularly in the first trimester, reflect the fact that women on insulin pumps had lower glucose levels already outside of pregnancy in the preconception period (69,70). This notion is further supported by our subgroup meta-analysis that showed a larger difference in first trimester HbA1c levels in relation to the MDI group in women who started pump therapy before pregnancy, compared to women who switched to CSII at the beginning of pregnancy.…”

Can we predict success of insulin pump therapy? (我们能够预测使用胰岛素泵治疗将会成功吗？)

“…The findings from the Register repeatedly show that CSII treatment is effective, even in the long term, and have its justified indications. 3 We evaluated 1729 patients with complete data for the first 2 years of insulin pump treatment from the database of patients treated by CSII over the period 1998-2012.…”