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在哥伦比亚麦德林的两个专业中心,对采用持续皮下胰岛素输注和实时连续血糖监测治疗的1型糖尿病孕妇的母婴结局进行研究。

Maternal and perinatal outcomes in pregnant women with type 1 diabetes treated with continuous subcutaneous insulin infusion and real time continuous glucose monitoring in two specialized centers in Medellin, Colombia.

作者信息

Restrepo-Moreno Mónica, Ramírez-Rincón Alex, Hincapié-García Jaime, Palacio Andrés, Monsalve-Arango Claudia, Aristizabal-Henao Natalia, Restrepo-Zapata Camila, Botero-Arango José Fernando

机构信息

a Department of Obstetrics and Gynecology , Universidad Pontificia Bolivariana , Medellín , Colombia.

b Endocrinology, Universidad Pontificia Bolivariana, Clínica Integral de Diabetes, IDEA Investigation Group , Medellín , Colombia.

出版信息

J Matern Fetal Neonatal Med. 2018 Mar;31(6):696-700. doi: 10.1080/14767058.2017.1295952. Epub 2017 Mar 6.

Abstract

OBJECTIVE

We assessed maternal and perinatal outcomes in pregnant women with type 1 diabetes, treated with continuous subcutaneous insulin infusion and real time continuous glucose monitoring.

METHODS

This is a retrospective study, analyzing the basal characteristics, glycemic control, maternal and perinatal outcomes of pregnant women with type 1 diabetes, who were on an insulin pump with continuous glucose monitoring between 2011 and 2015.

RESULTS

Fourteen patients were included. The median age was 33 and disease duration 12 years. Indications for therapy were mainly poor glycemic control and severe hypoglycemia. The median A1c decrease was 1.02% between the first and third trimester. Pregnancies were associated with complications: 7.1% of the patients had diabetic ketoacidosis, 7.1% had an abortion, 28.5% gestational hypertension and 12.2% preeclampsia. The median gestational age at birth was 37 weeks and four days; the frequency of preterm birth was 7.1% and macrosomia 21.4%. There were no congenital malformations or perinatal death.

CONCLUSIONS

Baseline characteristics and results of patients in this study were similar to those reported in the previous literature. Continuous subcutaneous insulin infusion with continuous glucose monitoring is an alternative treatment option for pregnant women with type 1 diabetes before or during pregnancy.

摘要

目的

我们评估了采用持续皮下胰岛素输注和实时连续血糖监测治疗的1型糖尿病孕妇的母婴及围产期结局。

方法

这是一项回顾性研究,分析了2011年至2015年间使用胰岛素泵并进行连续血糖监测的1型糖尿病孕妇的基础特征、血糖控制情况、母婴及围产期结局。

结果

纳入14例患者。中位年龄为33岁,病程12年。治疗指征主要是血糖控制不佳和严重低血糖。孕早期与孕晚期之间糖化血红蛋白(A1c)中位数下降1.02%。妊娠伴有并发症:7.1%的患者发生糖尿病酮症酸中毒,7.1%发生流产,28.5%发生妊娠期高血压,12.2%发生先兆子痫。出生时的中位孕周为37周零4天;早产发生率为7.1%,巨大儿发生率为21.4%。无先天性畸形或围产期死亡。

结论

本研究中患者的基线特征和结果与先前文献报道的相似。持续皮下胰岛素输注联合连续血糖监测是1型糖尿病孕妇在孕前或孕期的一种替代治疗选择。

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