Glycemic control in pregnant diabetic women using a continuous subcutaneous insulin infusion pump.

Five insulin-dependent diabetics in the third trimester of pregnancy were first stabilized on morning and evening injections of both short- and long-acting insulin. Blood sugars were determined hourly from 7 A.M. to 7 P.M. and then every two hours from 7 P.M. to 7 A.M. After glycemic control was established, the patients were treated with continuous subcutaneous insulin infusion via a pump that administers a basal dosage at predetermined intervals and bolus doses preprandially. Mean blood sugar, glycemic excursions and intervals of hypoglycemia and hyperglycemia were calculated after three to five days of infusion therapy. The continuous subcutaneous insulin infusion with the pump did not improve glycemic control in the group as a whole, but in two of five patients there was a significant decrease in mean blood sugar. A trend towards a decrease in glycemic excursions as well as hypoglycemia and hyperglycemia was also obtained. Three patients were managed with long-term home and in-hospital use of the continuous subcutaneous insulin infusion pump. It proved to be efficacious and safe in establishing euglycemia. This study of a portable insulin infusion pump affirms its ability to maintain glycemic control and its safety for long-term therapy during pregnancy.