Laatikainen L, Teramo K, Hieta-Heikurainen H, Koivisto V, Pelkonen R
Acta Med Scand. 1987;221(4):367-76. doi: 10.1111/j.0954-6820.1987.tb03358.x.
Forty consecutive pregnant patients with insulin-dependent (Type I) diabetes mellitus were randomized at the end of the first trimester for treatment with conventional insulin therapy (CIT) or continuous subcutaneous insulin infusion therapy (CSII). Nine patients randomized into the CSII group declined the pump treatment. The mean glycosylated haemoglobin (Hb AIc) decreased (p less than 0.001) both in the CIT and the CSII groups with no difference between the groups. Some deterioration in retinopathy was found in 2/18 patients in the CIT group, in 5/13 in the CSII group, and in 3/9 of those who declined the pump treatment. The proportion of patients whose retinopathy progressed did not differ significantly between the groups, and in the majority the deterioration was mild. However, two patients in the CSII group developed acute ischaemic retinopathy, which progressed to proliferative stage in spite of laser treatment. In these two cases the decrease in the Hb AIc level was among the greatest and fastest in the study. These data suggest that a rapid near normalization of glycaemic control by CSII during pregnancy can accelerate the progress of retinopathy in poorly controlled diabetic patients.
40例连续的胰岛素依赖型（I型）糖尿病孕妇在孕早期结束时被随机分为接受传统胰岛素治疗（CIT）或持续皮下胰岛素输注治疗（CSII）。随机分入CSII组的9例患者拒绝泵治疗。CIT组和CSII组的糖化血红蛋白（Hb AIc）均值均下降（p<0.001），两组间无差异。CIT组18例患者中有2例视网膜病变出现一些恶化，CSII组13例中有5例，拒绝泵治疗的9例中有3例。视网膜病变进展的患者比例在各组间无显著差异，且大多数恶化程度较轻。然而，CSII组有2例患者发生急性缺血性视网膜病变，尽管接受了激光治疗仍进展至增殖期。在这两例中，Hb AIc水平的下降是研究中最大且最快的。这些数据表明，孕期通过CSII使血糖控制迅速接近正常水平可加速控制不佳的糖尿病患者视网膜病变的进展。
