Pregnancy outcomes in an obstetrical Type I Diabetic patient population, Insulin pump vs insulin injections. [24P]

Abstract

INTRODUCTION: Objective: To analyze pregnancy outcomes between two different methods of insulin delivery in an obstetrical type I diabetic patient population. METHODS: Study Design: A retrospective chart review of an obstetrical type I diabetic was analyzed from a single institution. These patients were separated into those utilizing a continuous subcutaneous insulin pump (CSI) and those receiving multiple daily injections of insulin (MDDI). Subsequently, the data pertinent to the different antenatal and postnatal outcomes was collected. Statistical analysis with student t-test and Chi square test was done as applicable. RESULTS: There were no statistical differences in the outcomes between these two groups when comparing age, parity, gestational age, BMI, starting weight, weight at delivery, number of years since diagnosis, weight gain during pregnancy., neonatal birthweight, neonatal hypoglycemia, shoulder dystocia, macrosomia, and primary C-section rate. The HgA1C of the CSI was statistical significant lower when compared to MDDI in first trimester(p<.003), second (p<.03) and third trimester (p<.01).The total number of insulin units needed to treat patients in the CSI was statistically significant lower when compared to MDDI in the first(p<.04), second(p<.004) and third trimester(p<.006).The weight retention at 1 year postpartum was statistically significant lower in the CSI when compared to the MDDI (p<.04). CONCLUSION: Pregnancy outcomes were comparable between these two methods for many variables. However, CSI appears to offer an advantage in minimizing the insulin quantity needed during pregnancy and reducing weight retention postpartum in the setting of optimal blood sugar control.