MIAMI BEACH — Continuous subcutaneous insulin lispro infusion seems to be superior to multiple daily insulin lispro injections for the treatment of pregnant women with type 1 diabetes, Dr. Giorgio Mello said at the annual meeting of the Society for Maternal-Fetal Medicine.
In a randomized controlled study of 71 pregnant women with type 1 diabetes and 142 matched, nondiabetic, pregnant controls, continuous subcutaneous insulin infusions (CSII) were found to mimic more closely than multiple daily injections (given as a premeal bolus) the normal postprandial glucose excursion pattern, said Dr. Mello of the University of Florence, Italy.
Patients in both groups had similar average daily glucose levels. However, at 16−, 26−, and 36-week evaluations, those in the CSII group had 24-hour glycemic profiles similar to the normal group; those in the multiple daily injections group had a significantly longer time period in the three-meal postprandial areas.
Fetuses in the CSII group, but not in the multiple daily injection group, had growth patterns similar to those of controls, as measured by ultrasound scans performed every 2 weeks between 25 and 38 weeks' gestation, Dr. Mello noted.