Journal of Diabetes Investigation (Dec 2023)

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

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

DOI
https://doi.org/10.1111/jdi.14075
Journal volume & issue
Vol. 14, no. 12
pp. 1383 – 1390

Abstract

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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.

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