Effectively managing blood sugar can be difficult in normal situations, but it can be even more challenging during pregnancy. Women must be cognizant of not only their own health, but also that of their unborn child. Infants are at risk for neonatal hypoglycemia. A recent study examined the impact of multiple daily injections (MDI) versus using an insulin pump on glycemic control during pregnancy for women with type 1 diabetes.
The study involved 123 women using MDI therapy and 125 women with insulin pumps. The researchers based the study on the treatment the women were already using prior to the trial; they did not assign a treatment method. Participants spanned multiple countries including the United States, Canada, England, Ireland, Scotland, Spain, and Italy. Women entered the study during their first trimester, and it lasted until they were at 34 weeks of gestation.
During this time, HbA1c levels were measured. The results showed that both treatment methods were equally effective during the first trimester with no statistically significant differences. However, at 34 weeks gestation, women who used MDI therapy showed a greater decrease in HbA1c levels versus women using insulin pumps. In addition, insulin pump users reported higher levels of gestational hypertension, neonatal hypoglycemia, and neonatal intensive care unit admissions for longer than 24 hours. However, these women also reported lower levels of hypoglycemia-related anxiety than those using MDI therapy, but also had lower levels of general well-being.
Overall, it appeared that MDI therapy resulted in greater decreases in HbA1c levels and improved glycemic control. There is still more research necessary, however, to verify these results. There were several factors that may have influenced findings and outcomes.
This study shows the importance of understanding the effects of T1D on different conditions such as pregnancy and the value of researching various treatment options to help women make more informed decisions regarding their health. Though not involved in this study, the Diabetes Research Connection follows the latest trends and developments in the field and supports early career scientists by providing critical funding for novel research regarding T1D. Continued funding is essential for advancing research and diabetes care. To learn more, visit http://diabetesresearchconnection.org.