CONTINUOUS SUBCUTANEOUS INSULIN INFUSION (CSII) VS. MULTIPLE DAILY INJECTIONS (MDI) IN PREGNANT WOMEN WITH TYPE 1 DIABETES.

Background and aim:Continuous Subcutaneous Insulin Infusion(CSII) may be an alternative treatment to Multiple Daily Injections(MDI) in pregnant subjects with Type 1 Diabetes(¹). The aim of thisstudy was to compare metabolic control and obstetric outcome ofthese pregnancies treated with CSII vs. pregnancies treated withdifferent type of insulin analogs administrated by MDI.Material and methods:We studied 172 pregnancies in 150 women, threetwin pregnancies, affected by type 1 Diabetes. Thirty-four pregnanciestreated with CSII and 138 treated with MDI treatment were evaluated.In the group of women treated with MDI 78 women used humananalogs, 32 used insulin aspart and 28 used insulin lispro. Metaboliccontrol and obstetric outcome were compared between the groups.Results:We documented 164 live births (93.7%), eight miscarriages(4.7%) and two intrauterine deaths (1.2%). No significative differenceswere found between the groups in terms of: still birth, birth weight,birth weight percentile, week of delivery, preterm delivery, Caesareansection, pre-eclampsia, macrosomia and Apgar Score<7. No statistically significant differences were found in metabolic control interm of HbA1c mean level for each trimester of pregnancy.Conclusion:No clear advantage of CSII vs. MDI treatment is shownin our study for pregnancies complicated by type 1 Diabetes in termof metabolic control or obstetric outcome(²). However, it might bethat some selected patients with unstable metabolic control or highHbA1c levels, who become pregnant with a better metabolic profileafter CSII treatment, may have a better pregnancy outcome