Changes in basal rates and bolus calculator settings in insulin pumps during pregnancy in women with type 1 diabetes

TY - JOUR

T1 - Changes in basal rates and bolus calculator settings in insulin pumps during pregnancy in women with type 1 diabetes

AU - Mathiesen, Jonathan M

AU - Secher, Anna L

AU - Ringholm, Lene

AU - Nørgaard, Kirsten

AU - Hommel, Eva

AU - Andersen, Henrik U

AU - Damm, Peter

AU - Mathiesen, Elisabeth R

PY - 2014/4

Y1 - 2014/4

N2 - OBJECTIVE: To explore insulin pump settings in a cohort of pregnant women with type 1 diabetes on insulin pump therapy with a bolus calculator.METHODS: Twenty-seven women with type 1 diabetes on insulin pump therapy were included in this study. At 8, 12, 21, 27 and 33 weeks, insulin pump settings and HbA1c were recorded. Results were compared with 96 women with type 1 diabetes on multiple daily injection therapy.RESULTS: Throughout pregnancy, the carbohydrate-to-insulin ratio decreased at all three main meals. The most pronounced decrease was observed at breakfast, where the carbohydrate-to-insulin ratio was reduced, from median 12 (range 4-20) in early pregnancy to 3 (2-10) g carbohydrate per unit insulin in late pregnancy. Basal insulin delivery increased by ∼50%, i.e. from 0.8 (0.5-2.2) to 1.2 (0.6-2.5) IU/h at 5 a.m. and from 1.0 (0.6-1.5) to 1.3 (0.2-2.3) IU/h at 5 p.m. during pregnancy. HbA1c levels during pregnancy, the occurrence of severe hypoglycemia and pregnancy outcomes were similar in the two groups.CONCLUSIONS: In women with type 1 diabetes on insulin pump therapy with a bolus calculator, the carbohydrate-to-insulin ratio declined 4-fold from early to late pregnancy, whereas changes in basal insulin delivery were smaller.

AB - OBJECTIVE: To explore insulin pump settings in a cohort of pregnant women with type 1 diabetes on insulin pump therapy with a bolus calculator.METHODS: Twenty-seven women with type 1 diabetes on insulin pump therapy were included in this study. At 8, 12, 21, 27 and 33 weeks, insulin pump settings and HbA1c were recorded. Results were compared with 96 women with type 1 diabetes on multiple daily injection therapy.RESULTS: Throughout pregnancy, the carbohydrate-to-insulin ratio decreased at all three main meals. The most pronounced decrease was observed at breakfast, where the carbohydrate-to-insulin ratio was reduced, from median 12 (range 4-20) in early pregnancy to 3 (2-10) g carbohydrate per unit insulin in late pregnancy. Basal insulin delivery increased by ∼50%, i.e. from 0.8 (0.5-2.2) to 1.2 (0.6-2.5) IU/h at 5 a.m. and from 1.0 (0.6-1.5) to 1.3 (0.2-2.3) IU/h at 5 p.m. during pregnancy. HbA1c levels during pregnancy, the occurrence of severe hypoglycemia and pregnancy outcomes were similar in the two groups.CONCLUSIONS: In women with type 1 diabetes on insulin pump therapy with a bolus calculator, the carbohydrate-to-insulin ratio declined 4-fold from early to late pregnancy, whereas changes in basal insulin delivery were smaller.

KW - Algorithms

KW - Cohort Studies

KW - Diabetes Mellitus, Type 1

KW - Female

KW - Humans

KW - Hypoglycemic Agents

KW - Insulin

KW - Insulin Infusion Systems

KW - Pregnancy

KW - Pregnancy in Diabetics

U2 - 10.3109/14767058.2013.837444

DO - 10.3109/14767058.2013.837444

M3 - Journal article

C2 - 23981186

SN - 1476-7058

VL - 27

SP - 724

EP - 728

JO - Journal of Maternal-Fetal Medicine

JF - Journal of Maternal-Fetal Medicine

IS - 7

ER -