Gestational diabetes can be safely managed using insulin pumps


WESTPORT, CT (Reuters Health) – Insulin pump therapy is safe and effective for maintaining glycemic control in women with gestational diabetes mellitus (GDM) or type 2 diabetes in pregnancy requiring large doses of insulin, according to a report in the December issue of Diabetes Care.

In a nested case-control study, Dr. David Simmons, of the University of Melbourne, Australia, and colleagues, compared pregnancies complicated by GDM/type 2 diabetes in which an insulin pump was used with those without insulin pump therapy. The patients were matched for ethnicity and type of diabetes.

Of 251 Polynesian, European, and South Asian women with such pregnancies, 30 (12%) used an insulin pump. Two women discontinued pump therapy, resulting in a failure rate of 6.7%. [

None of the women using an insulin pump experienced severe hypoglycemia, the researchers note. Seventy-nine percent of the women demonstrated improved glycemic control within 1 to 2 weeks, 14% improved within 4 weeks, and the remainder improved within 6 weeks.

Mothers using a pump had greater insulin requirement than those not using a pump, with mean maximum requirements of 246 units/day and 130 units/day, respectively. In addition, they had greater weight gain, at 10.6 kg versus 5.0 kg.

"Their babies were more likely to be admitted to the Special Care Baby Unit but were neither significantly heavier nor experienced greater hypoglycemia than control subjects," Dr. Simmons and colleagues point out.

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