Evaluation of Glycaemic Control, Glucose Variability and Hypoglycaemia on Long-Term Continuous Subcutaneous Infusion vs. Multiple Daily Injections: Observational Study in Pregnancies With Pre-Existing Type 1 Diabetes

Jotić, Aleksandra; Miličić, Tanja; Lalić, Katarina; Lukic, Ljiljana; Maćešić, Marija; Gajović, Jelena Stanarčić; Stoiljković, Milica; Dugalić, Miroslava Gojnić; Jeremić, Veljko; Lalić, Nebojša

doi:10.1007/s13300-020-00780-7

Cited by 11 publications

(25 citation statements)

References 32 publications

(43 reference statements)

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“…Cyganek et al [ 27 ] (SQ) reported that the proportion of cesarean deliveries was larger in women using insulin pumps (no P value reported) because of clinical factors such as age, duration of diabetes, and microvascular complications. Feig et al [ 29 ] (MQ) (IG: n=81 vs CG: n=74, P =.32) and Jotic et al [ 28 ] (SQ) (IG: n=12 vs CG: n=13, P =.20) found no significant differences between groups.…”

Section: Resultsmentioning

confidence: 97%

“…In general, 2 cohort studies [ 27 , 28 ], 1 randomized controlled trials [ 29 ], 1 randomized crossover trial [ 30 ] analyzing 148 intervention and 495 control participants were identified.…”

Section: Resultsmentioning

confidence: 99%

“…Overall, 3 studies found positive effects on HbA 1c levels in favor of continuous subcutaneous insulin infusion. Jotic et al [ 28 ] (SQ) found a significant lower mean HbA 1c level in their intervention group than that in the control group at follow-up (6.5% intervention vs 6.8% control, P =.002). Cyganek et al [ 27 ] (SQ) also reported significant improvements in HbA 1c within all their treatment groups but did not find significant differences between groups.…”

Section: Resultsmentioning

confidence: 99%

“…Jotic et al [ 28 ] (SQ) reported that in early pregnancy, the majority of women on continuous subcutaneous insulin infusion had significantly fewer instances of hypoglycemia ( P <.01), but Cyganek et al [ 27 ] (SQ) found fewer instances of severe hypoglycemia in their control group ( P =.04).…”

Section: Resultsmentioning

confidence: 99%

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Clinical Effectiveness of Different Technologies for Diabetes in Pregnancy: Systematic Literature Review

Eberle¹,

Löhnert²,

Stichling³

2021

J Med Internet Res

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Background Hyperglycemia in pregnancy occurs worldwide and is closely associated with health issues in women and their offspring, such as pregnancy and birth complications, respectively, as well as comorbidities, such as metabolic and cardiovascular diseases. To optimize the management of diabetic pregnancies, sustainable strategies are urgently needed. Investigation of constantly evolving technologies for diabetes that help to manage pregnancy and health is required. Objective We aimed to conduct a systematic review to assess the clinical effectiveness of technologies for diabetes in pregnancy. Methods Relevant databases including MEDLINE (PubMed), Cochrane Library, Embase, CINAHL, and Web of Science Core Collection were searched in September 2020 for clinical studies (2008-2020). Findings were organized by type of diabetes, type of technology, and outcomes (glycemic control, pregnancy- and birth-related outcomes, and neonatal outcomes). Study quality was assessed using Effective Public Health Practice Project criteria. Results We identified 15 randomized controlled trials, 3 randomized crossover trials, 2 cohort studies, and 2 controlled clinical trials. Overall, 9 studies focused on type 1 diabetes, 0 studies focused on gestational diabetes, and 3 studies focused on both type 1 diabetes and type 2 diabetes. We found that 9 studies were strong quality, 11 were moderate quality, and 2 were weak quality. Technologies for diabetes seemed to have particularly positive effects on glycemic control in all types of diabetes, shown by some strong and moderate quality studies. Positive trends in pregnancy-related, birth-related, and neonatal outcomes were observed. Conclusions Technologies have the potential to effectively improve the management of diabetes during pregnancy. Further research on the clinical effectiveness of these technologies is needed, especially in pregnant women with type 2 diabetes.

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Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Clinical Effectiveness of Different Technologies for Diabetes in Pregnancy: Systematic Literature Review

Eberle¹,

Löhnert²,

Stichling³

2021

J Med Internet Res

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show abstract

“…This factor can be considered a better predictor of neonatal hypoglycaemia, compared to maternal glycaemic control [ 24 ]. It has been suggested that glycaemic fluctuations and hypoglycaemia may influence the course of pregnancy in women with long-standing T1DM, but the effectiveness of different insulin treatments for glycaemic control and variability and hypoglycaemic episodes in pregnant women with T1DM has not been elucidated [ 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

Maternal-foetal complications in pregnancy: a retrospective comparison between type 1 and type 2 diabetes mellitus

Guarnotta

Mineo

Giacchetto

et al. 2021

BMC Pregnancy Childbirth

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Background The aim of the study was a retrospective comparison of the differences in maternal-foetal outcomes between women with type 1 and type 2 diabetes mellitus (T1DM and T2DM). Methods A cohort of 135 patients with pregestational diabetes, 73 with T1DM (mean age 29 ± 5 years) and 62 with T2DM (mean age 33 ± 6 years), in intensive insulin treatment throughout pregnancy were evaluated. Clinical and metabolic parameters and the prevalence of maternal and foetal complications were assessed. Results Women with T1DM showed lower pregestational BMI (p < 0.001), pregestational weight (p < 0.001), weight at delivery (p < 0.001), ∆_total_insulin requirement (IR) at the first, second and third trimesters (all p < 0.001) and higher weight gain during pregnancy (p < 0.001), pregestational HbA1c (p = 0.040), HbA1c in the first (p = 0.004), second (p = 0.020) and third (p = 0.010) trimesters compared to T2DM. Women with T1DM had a higher risk of macrosomia (p = 0.005) than T2DM, while women with T2DM showed higher prevalence of abortion (p = 0.037) than T1DM. At multivariate analysis, pregestational BMI and ∆_total_IR of the first trimester were independently associated with abortion in T2DM, while weight gain during pregnancy was independently associated with macrosomia in T1DM. Conclusion Women with T1DM have a higher risk of macrosomia than T2DM due to weight gain throughout pregnancy. By contrast, women with T2DM have a higher risk of spontaneous abortion than T1DM, due to pregestational BMI and ∆_total_IR in the first trimester.

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A sensor-augmented pump with a predictive low-glucose suspend system could lead to an optimal time in target range during pregnancy in Japanese women with type 1 diabetes

Tamura,

Kodani,

Itoh

et al. 2024

Diabetol Int

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Evaluation of Glycaemic Control, Glucose Variability and Hypoglycaemia on Long-Term Continuous Subcutaneous Infusion vs. Multiple Daily Injections: Observational Study in Pregnancies With Pre-Existing Type 1 Diabetes

Abstract: Introduction:We evaluated the effectiveness of long-term continuous subcutaneous insulin infusion (CSII) compared with multiple daily insulin (MDI) injections for glycaemic control

Cited by 11 publications

References 32 publications

Clinical Effectiveness of Different Technologies for Diabetes in Pregnancy: Systematic Literature Review

Clinical Effectiveness of Different Technologies for Diabetes in Pregnancy: Systematic Literature Review

Maternal-foetal complications in pregnancy: a retrospective comparison between type 1 and type 2 diabetes mellitus

A sensor-augmented pump with a predictive low-glucose suspend system could lead to an optimal time in target range during pregnancy in Japanese women with type 1 diabetes

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