Maja Baretic, Croatia

University Hospital Centre Zagreb Department of Endocrinology and Diabetes

Presenter of 1 Presentation

PREGNANCY WITH TYPE I DIABETES TREATED WITH AN INSULIN PUMP. RISKS FOR LARGE FOR GESTATIONAL AGE INFANTS AND ALTERNATING BASAL-BOLUS INSULIN RATIO

Session Name
INSULIN PUMPS
Session Type
E-POSTER VIEWING (EXHIBITION HOURS)
Date
20.02.2020, Thursday
Session Time
09:30 - 15:30
Channel
E-Poster Area
Lecture Time
09:32 - 09:33

Abstract

Background and Aims

The aim of this study was to identify parameters that contribute the most to the development of large for gestational age (LGA) infants in a cohort of patients with type 1 diabetes mellitus (T1DM) treated with an insulin pump during pregnancy. Furthemore, basal and bolus insulin changes during pregnancy were evaluated.

Methods

The data of patients was retrospectively analyzed. Inclusion criteria were HbA1c ≤7.0% (53mmol/mol), BMI (body mass index) <25kg/m2 at the time of conception, duration of T1DM for more than 2 years and treatment with insulin pump for at least 3 months prior to conception. A total of 14 patients were included. Statistical analysis was performed using Wilcoxon signed ranks test and linear regression.

Results

Among several analyzed parameters, only HbA1c in the last trimester was extracted as a significant predictor of birth weight (R square=0.653). Furthermore, preconception maternal body weight correlated positively with HbA1c in the last trimester (p=0.026, r=0.592). Regarding insulin changes, total daily insulin dose (TDI) increased 33% from the conception to the last trimester, 34.7U (13.4-50.6) and 46.2 U (17.5-87.0), respectively. Most of the TDI increase was attributed to the rise of bolus insulin while basal insulin remained fairly constant with basal-bolus insulin ratio changing from 52/48 to 39/61

Conclusions

Preconception body weight and optimal glycemic control during pregnancy, especially in the last trimester, are essential for reducing risk of LGA neonates. Regarding insulin changes, there should be emphasis on increase of bolus insulin as pregnancy progresses.

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