ISSN: 1301-2193 E-ISSN: 1308-9846
  • Turkish Journal of
    Endocrinology and Metabolism
ORIGINAL ARTICLE

Acute Complications and Pregnancy Outcomes with Continuous Subcutaneous Insulin Infusion Therapy in Pregnant Women with Type 1 Diabetes Mellitus
Tip 1 Diabetes Mellitusu Olan Gebelerde Sürekli Subkütan İnsülin İnfüzyon Tedavisinin Akut Komplikasyonlar ve Gebelik Sonlanımı Üzerine Etkisi
Received Date : 01 Mar 2020
Accepted Date : 26 Apr 2020
Available Online : 06 May 2020
Doi: 10.25179/tjem.2020-74444 - Makale Dili: EN
Turk J Endocrinol Metab. 2020;24;109-114
Bu makale, CC BY-NC-SA altında lisanslanmış açık erişim bir makaledir.
ABSTRACT
Objective: Pregnant women with type 1 diabetes mellitus (T1DM) have increased risk of fetal, maternal, and perinatal complications. In this report, we aimed to evaluate the effects of continuous subcutaneous insulin infusion (CSII) therapy on pregnancy outcomes, glycemic control, and acute complications in pregnant women with T1DM. Material and Methods: We retrospectively analyzed the data of 15 women with T1DM who were on CSII therapy during their pregnancy, and who were followed up at our clinic between 2008 and 2014. Acute complications, fetal/maternal, and perinatal complications, and glycemic control were analyzed. Results: The mean age of the patients was 28.2±3.6 years, and the mean duration of diabetes was 8±5.4 years. We did not observe severe hypoglycemic episodes and diabetic ketoacidosis during their pregnancy. The mean HbA1c levels at 4-8 weeks of pregnancy decreased from 7.4±1.3% to 6.3±0.7% at 34-38 weeks of pregnancy. The mean duration of pregnancy and neonatal birth weight were 37.1±1.2 weeks and 3.537±794 g, respectively. There were no stillbirths, perinatal infant deaths, or congenital malformations noted. There were two preterm births due to preeclampsia, one of whom had a low birth weight (1.800 g). We recorded one macrosomic baby (4.730 g). Conclusion: We observed that glycemic control improved with CSII therapy during pregnancy. We did not detect severe hypoglycemia or diabetic ketoacidosis in our research. In pregnant women with T1DM who had inadequate glycemic control with multiple daily insulin injection therapy, CSII might be a safe and appropriate treatment regimen.
ÖZET
Amaç: Tip 1 diabetes mellituslu (T1DM) gebe kadınlarda fetal, maternal ve perinatal komplikasyon riski artmıştır. Bu raporda, T1DM'li gebelerde sürekli subkütan insülin infüzyonu [continuous subcutaneous insulin infusion (CSII)]nun gebelik sonuçları, glisemik kontrol ve akut komplikasyonlar üzerine etkilerini değerlendirmeyi amaçladık. Gereç ve Yöntemler: 2008-2014 yılları arasında kliniğimizde izlenen CSII tedavisi alan T1DM’li 15 kadının verileri retrospektif olarak incelendi. Akut komplikasyonlar, fetal/maternal ve perinatal komplikasyonlar ile glisemik kontrol analiz edildi. Bulgular: Hastaların ortalama yaşı 28,2±3,6 yıl, ortalama diyabet süresi ise 8±5,4 yıl idi. Gebelikleri sırasında şiddetli hipoglisemik atak ve diyabetik ketoasidoz izlenmedi. Gebeliğin 4-8. haftalarında ölçülen ortalama HbA1c, gebeliğin 34-38. haftalarında %7,4±1,3'ten %6,3±0,7'ye geriledi. Ortalama gebelik süresi ve yenidoğan doğum ağırlığı sırasıyla 37,1±1,2 hafta ve 3.537±794 g idi. Ölü doğum, perinatal bebek ölümü veya konjenital malformasyon görülmedi. Preeklampsi nedeni ile iki preterm doğum görüldü. Bu yenidoğanlardan biri düşük doğum ağırlığına (1.800 g) sahipti. Bir makrozomik bebek kaydedildi (4.730 g). Sonuç: Çalışmamızda gebelik sırasında CSII tedavisi ile glisemik kontrolde düzelme izlendi, şiddetli hipoglisemi veya diyabetik ketoasidoz saptanmadı. Günlük çoklu enjeksiyon (MDI) tedavisi ile glisemik kontrolü sağlanamayan T1DM'li gebe kadınlarda, CSII tedavisinin güvenli ve uygun bir tedavi rejimi olabileceği sonucuna vardık.
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