妊娠合并 1 型糖尿病患者采用持续皮下胰岛素输注与多次皮下注射胰岛素的疗效比较。
Continuous subcutaneous insulin infusion versus multiple daily injections in pregnant women with type 1 diabetes.
机构信息
Endocrinology and Nutrition, Hospital Regional Universitario Carlos Haya, Avenida del Dr. Gálvez Ginachero S/N, Malaga, Spain.
出版信息
Diabetes Technol Ther. 2010 Apr;12(4):263-9. doi: 10.1089/dia.2009.0140.
BACKGROUND
Continuous subcutaneous insulin infusion (CSII) may be an alternative to multiple daily injections (MDI) in pre-gestational 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.
背景
在妊娠期间，对于孕前糖尿病患者，连续皮下胰岛素输注（CSII）可能是多次皮下注射（MDI）的替代疗法。然而，目前为止，CSII 治疗并未明确改善产科和围产结局。
方法
在一项病例对照研究中，评估了 35 例接受 CSII 治疗的妊娠和 64 例接受 MDI 治疗的妊娠。比较了代谢控制以及产科和围产结局。
结果
CSII 组的女性改善了其代谢控制（CSII 治疗前的血红蛋白 A1c 为 7.83 +/- 0.97%；治疗后 3-6 个月为 6.77 +/- 0.61%；P < 0.05）。CSII 组的孕前血红蛋白 A1c 水平（6.62 +/- 0.60%）低于 MDI 组（7.59 +/- 1.61%）（P < 0.05）。在糖尿病的代谢控制或产科和围产结局方面，未发现其他显著差异。
结论
CSII 治疗在妊娠期间是安全的，但与改善妊娠结局无关。
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