Evaluation of Glycaemic Control, Glucose Variability and Hypoglycaemia on Long-Term Continuous Subcutaneous Infusion vs. Multiple Daily Injections: Observational Study in Pregnancies With Pre-Existing Type 1 Diabetes
2020
Preuzimanje 🢃
Autori
Jotić, AleksandraMiličić, Tanja
Lalić, Katarina
Lukić, Ljiljana
Maćešić, Marija
Stanarčić Gajović, Jelena
Stoiljković, Milica
Gojnic Dugalić, Miroslava
Jeremić, Veljko
Lalić, Nebojša M.
Članak u časopisu (Objavljena verzija)
Metapodaci
Prikaz svih podataka o dokumentuApstrakt
Introduction We evaluated the effectiveness of long-term continuous subcutaneous insulin infusion (CSII) compared with multiple daily insulin (MDI) injections for glycaemic control and variability, hypoglycaemic episodes and maternal/neonatal outcomes in pregnant women with pre-existing type 1 diabetes (pT1D). Methods Our observational cohort study included 128 consecutive pregnant women with pT1D, who were treated from 1 January 2010 to 31 December 2017. Of 128 participants, 48 were on CSII and 80 were on MDI. Glycaemic control was determined by glycated haemoglobin (HbA1c) (captured in preconception and each trimester of pregnancy). Glucose variability (GV) was expressed as the coefficient of variation (CV) [calculated from self-monitoring of blood glucose (SMBG) values], and hypoglycaemia was defined as glucose values LT 3.9 mmol/l. The data on maternal and neonatal outcomes were collected from obstetrical records. Results Duration of the treatment was 8.8 +/- 5.3 years in the CSI...I and 12.6 +/- 8.0 years in the MDI group. The CSII lowered HbA1c in preconception (7.1 +/- 0.1 vs. 7.9 +/- 0.2%, p = 0.03) and the first (6.9 +/- 0.1 vs. 7.7 +/- 0.2%, p = 0.02), second (6.6 +/- 0.1 vs. 7.2 +/- 0.1%, p = 0.003) and third (6.5 +/- 0.1 vs. 6.8 +/- 0.1%, p = 0.02) trimesters significantly better than MDI. Significantly lower CV was observed only for fasting glycaemia in the first trimester (17.1 vs 28.4%, p LT 0.001) in favour of CSII. Moreover, the CSII group had significantly lower mean hypoglycaemic episodes/week/patient only during the first trimester (2.0 +/- 1.7 vs 4.8 +/- 1.5, p LT 0.01). In early pregnancy, the majority of women on CSII had less hypoglycaemia than on MDI (0-3: 79.1 vs. 29.1%; 4-6: 18.8 vs. 65.8%; >= 7: 2.1 vs. 5.1%, p LT 0.01, respectively). We found no difference in the incidence of adverse maternal/neonatal outcomes. Conclusions Treatment with CSII resulted in a favourable reduction of HbA1c in the preconception period and each trimester in pregnancy. Moreover, long-term CSII treatment demonstrated more stable metabolic control with less GV of fasting glycaemia and fewer hypoglyacemic episodes only during early pregnancy.
Ključne reči:
Type 1 diabetes / Pregnancy / Glucose variability / Continuous subcutaneous insulin infusionIzvor:
Diabetes Therapy, 2020, 11, 4, 845-858Izdavač:
- Springer Heidelberg, Heidelberg
Finansiranje / projekti:
- Insulinska rezistencija: poređenje uloge u nastanku i razvoju tipa 2 dijabetesa, aterosklerozne vaskularne bolesti i neurodegenerativnih oboljenja (RS-MESTD-Basic Research (BR or ON)-175097)
DOI: 10.1007/s13300-020-00780-7
ISSN: 1869-6953
PubMed: 32060738
WoS: 000516112200001
Scopus: 2-s2.0-85079697520
Institucija/grupa
Fakultet organizacionih naukaTY - JOUR AU - Jotić, Aleksandra AU - Miličić, Tanja AU - Lalić, Katarina AU - Lukić, Ljiljana AU - Maćešić, Marija AU - Stanarčić Gajović, Jelena AU - Stoiljković, Milica AU - Gojnic Dugalić, Miroslava AU - Jeremić, Veljko AU - Lalić, Nebojša M. PY - 2020 UR - https://rfos.fon.bg.ac.rs/handle/123456789/2049 AB - Introduction We evaluated the effectiveness of long-term continuous subcutaneous insulin infusion (CSII) compared with multiple daily insulin (MDI) injections for glycaemic control and variability, hypoglycaemic episodes and maternal/neonatal outcomes in pregnant women with pre-existing type 1 diabetes (pT1D). Methods Our observational cohort study included 128 consecutive pregnant women with pT1D, who were treated from 1 January 2010 to 31 December 2017. Of 128 participants, 48 were on CSII and 80 were on MDI. Glycaemic control was determined by glycated haemoglobin (HbA1c) (captured in preconception and each trimester of pregnancy). Glucose variability (GV) was expressed as the coefficient of variation (CV) [calculated from self-monitoring of blood glucose (SMBG) values], and hypoglycaemia was defined as glucose values LT 3.9 mmol/l. The data on maternal and neonatal outcomes were collected from obstetrical records. Results Duration of the treatment was 8.8 +/- 5.3 years in the CSII and 12.6 +/- 8.0 years in the MDI group. The CSII lowered HbA1c in preconception (7.1 +/- 0.1 vs. 7.9 +/- 0.2%, p = 0.03) and the first (6.9 +/- 0.1 vs. 7.7 +/- 0.2%, p = 0.02), second (6.6 +/- 0.1 vs. 7.2 +/- 0.1%, p = 0.003) and third (6.5 +/- 0.1 vs. 6.8 +/- 0.1%, p = 0.02) trimesters significantly better than MDI. Significantly lower CV was observed only for fasting glycaemia in the first trimester (17.1 vs 28.4%, p LT 0.001) in favour of CSII. Moreover, the CSII group had significantly lower mean hypoglycaemic episodes/week/patient only during the first trimester (2.0 +/- 1.7 vs 4.8 +/- 1.5, p LT 0.01). In early pregnancy, the majority of women on CSII had less hypoglycaemia than on MDI (0-3: 79.1 vs. 29.1%; 4-6: 18.8 vs. 65.8%; >= 7: 2.1 vs. 5.1%, p LT 0.01, respectively). We found no difference in the incidence of adverse maternal/neonatal outcomes. Conclusions Treatment with CSII resulted in a favourable reduction of HbA1c in the preconception period and each trimester in pregnancy. Moreover, long-term CSII treatment demonstrated more stable metabolic control with less GV of fasting glycaemia and fewer hypoglyacemic episodes only during early pregnancy. PB - Springer Heidelberg, Heidelberg T2 - Diabetes Therapy T1 - Evaluation of Glycaemic Control, Glucose Variability and Hypoglycaemia on Long-Term Continuous Subcutaneous Infusion vs. Multiple Daily Injections: Observational Study in Pregnancies With Pre-Existing Type 1 Diabetes EP - 858 IS - 4 SP - 845 VL - 11 DO - 10.1007/s13300-020-00780-7 UR - conv_2269 ER -
@article{ author = "Jotić, Aleksandra and Miličić, Tanja and Lalić, Katarina and Lukić, Ljiljana and Maćešić, Marija and Stanarčić Gajović, Jelena and Stoiljković, Milica and Gojnic Dugalić, Miroslava and Jeremić, Veljko and Lalić, Nebojša M.", year = "2020", abstract = "Introduction We evaluated the effectiveness of long-term continuous subcutaneous insulin infusion (CSII) compared with multiple daily insulin (MDI) injections for glycaemic control and variability, hypoglycaemic episodes and maternal/neonatal outcomes in pregnant women with pre-existing type 1 diabetes (pT1D). Methods Our observational cohort study included 128 consecutive pregnant women with pT1D, who were treated from 1 January 2010 to 31 December 2017. Of 128 participants, 48 were on CSII and 80 were on MDI. Glycaemic control was determined by glycated haemoglobin (HbA1c) (captured in preconception and each trimester of pregnancy). Glucose variability (GV) was expressed as the coefficient of variation (CV) [calculated from self-monitoring of blood glucose (SMBG) values], and hypoglycaemia was defined as glucose values LT 3.9 mmol/l. The data on maternal and neonatal outcomes were collected from obstetrical records. Results Duration of the treatment was 8.8 +/- 5.3 years in the CSII and 12.6 +/- 8.0 years in the MDI group. The CSII lowered HbA1c in preconception (7.1 +/- 0.1 vs. 7.9 +/- 0.2%, p = 0.03) and the first (6.9 +/- 0.1 vs. 7.7 +/- 0.2%, p = 0.02), second (6.6 +/- 0.1 vs. 7.2 +/- 0.1%, p = 0.003) and third (6.5 +/- 0.1 vs. 6.8 +/- 0.1%, p = 0.02) trimesters significantly better than MDI. Significantly lower CV was observed only for fasting glycaemia in the first trimester (17.1 vs 28.4%, p LT 0.001) in favour of CSII. Moreover, the CSII group had significantly lower mean hypoglycaemic episodes/week/patient only during the first trimester (2.0 +/- 1.7 vs 4.8 +/- 1.5, p LT 0.01). In early pregnancy, the majority of women on CSII had less hypoglycaemia than on MDI (0-3: 79.1 vs. 29.1%; 4-6: 18.8 vs. 65.8%; >= 7: 2.1 vs. 5.1%, p LT 0.01, respectively). We found no difference in the incidence of adverse maternal/neonatal outcomes. Conclusions Treatment with CSII resulted in a favourable reduction of HbA1c in the preconception period and each trimester in pregnancy. Moreover, long-term CSII treatment demonstrated more stable metabolic control with less GV of fasting glycaemia and fewer hypoglyacemic episodes only during early pregnancy.", publisher = "Springer Heidelberg, Heidelberg", journal = "Diabetes Therapy", title = "Evaluation of Glycaemic Control, Glucose Variability and Hypoglycaemia on Long-Term Continuous Subcutaneous Infusion vs. Multiple Daily Injections: Observational Study in Pregnancies With Pre-Existing Type 1 Diabetes", pages = "858-845", number = "4", volume = "11", doi = "10.1007/s13300-020-00780-7", url = "conv_2269" }
Jotić, A., Miličić, T., Lalić, K., Lukić, L., Maćešić, M., Stanarčić Gajović, J., Stoiljković, M., Gojnic Dugalić, M., Jeremić, V.,& Lalić, N. M.. (2020). Evaluation of Glycaemic Control, Glucose Variability and Hypoglycaemia on Long-Term Continuous Subcutaneous Infusion vs. Multiple Daily Injections: Observational Study in Pregnancies With Pre-Existing Type 1 Diabetes. in Diabetes Therapy Springer Heidelberg, Heidelberg., 11(4), 845-858. https://doi.org/10.1007/s13300-020-00780-7 conv_2269
Jotić A, Miličić T, Lalić K, Lukić L, Maćešić M, Stanarčić Gajović J, Stoiljković M, Gojnic Dugalić M, Jeremić V, Lalić NM. Evaluation of Glycaemic Control, Glucose Variability and Hypoglycaemia on Long-Term Continuous Subcutaneous Infusion vs. Multiple Daily Injections: Observational Study in Pregnancies With Pre-Existing Type 1 Diabetes. in Diabetes Therapy. 2020;11(4):845-858. doi:10.1007/s13300-020-00780-7 conv_2269 .
Jotić, Aleksandra, Miličić, Tanja, Lalić, Katarina, Lukić, Ljiljana, Maćešić, Marija, Stanarčić Gajović, Jelena, Stoiljković, Milica, Gojnic Dugalić, Miroslava, Jeremić, Veljko, Lalić, Nebojša M., "Evaluation of Glycaemic Control, Glucose Variability and Hypoglycaemia on Long-Term Continuous Subcutaneous Infusion vs. Multiple Daily Injections: Observational Study in Pregnancies With Pre-Existing Type 1 Diabetes" in Diabetes Therapy, 11, no. 4 (2020):845-858, https://doi.org/10.1007/s13300-020-00780-7 ., conv_2269 .