Continuous Subcutaneous Insulin Infusion Versus Multiple Daily Injections in Pregnant Women with Type 1 Diabetes

Background: Continuous subcutaneous insulin infusion (CSII) may be an alternative to multiple daily injections (MDI) in pregestational diabetes during pregnancy. However, no clear improvement in obstetric and perinatal outcome has so far been established for CSII treatment. Methods: In a case-control study, 35 pregnancies treated with CSII and 64 pregnancies treated with MDI treatment were evaluated. Metabolic control and obstetric and perinatal outcome were compared. Results: Women in the CSII group improved their metabolic control (hemoglobin A1c before CSII, 7.83 +/- 0.97%; 3-6 months after, 6.77 +/- 0.61%; P < 0.05). Hemoglobin A1c before pregnancy was lower in the CSII group (6.62 +/- 0.60%) than in the MDI group (7.59 +/- 1.61%) (P < 0.05). No other significant differences, either in metabolic control of diabetes or in obstetric and perinatal outcome, were found. Conclusions: CSII treatment is safe in pregnancy, but it has not yet been associated with any improved pregnancy outcome.