Continuous subcutaneous insulin therapy during early pregnancy.

Area of Science:

• Endocrinology
• Obstetrics
• Metabolic Disorders

Background:

• Intensive metabolic control is crucial for early embryonic development in diabetic pregnancies.
• Continuous subcutaneous insulin infusion (CSII) therapy offers a potential method for achieving tight glycemic control.

Purpose of the Study:

• To evaluate the efficacy and safety of CSII during the critical 5th to 10th week of gestation.
• To assess the complication rates associated with CSII in pregnant individuals.

Main Methods:

• Twenty-four insulin-dependent pregnant individuals were trained in self-monitoring and CSII using the Auto Syringe AS6C pump.
• Regular insulin was administered via basal infusion and mealtime/snack boluses.

Main Results:

• Achieved reasonable control of fasting (119 +/- 30 mg/dL) and postprandial (133 +/- 34 mg/dL) hyperglycemia.
• An average of 2.2 +/- 1.5 symptomatic hypoglycemic episodes occurred weekly.
• Complication frequency decreased with increased provider experience.

Conclusions:

• CSII demonstrates efficacy in managing diabetes during early pregnancy.
• The therapy's safety profile improved with experience, indicating a learning curve.
• Further controlled trials comparing CSII with intensive conventional therapy are warranted.