Abstract:
OBJECTIVE:The aim of the study was to compare pregnancy outcomes with glycemic control, total increase in insulin requirement, and body weight gain in the women with Type 1 Diabetes Mellitus (T1DM) using continuous subcutaneous insulin infusion (CSII) or multiple daily injections (MDI). MATERIAL AND METHODS:This was a single center retrospective observational study involving 209 pregnant Caucasian women. Among the study participants, 95 subjects were treated with MDI and 114 patients were using CSII therapy. The primary outcomes were pregnancy results, while secondary ones were HbA1c, increase in daily dose of insulin (DDI), and body weight gain. RESULTS:At baseline, the CSII users were older (P = 0.0373), they were diagnosed with T1DM at a younger age (P = 0.047), and more often planned pregnancy (P = 0.032). A majority of the women were classified as class D, according to the White classification. Among the CSII users, a significantly higher proportion of the subjects in class B was noted than in the MDI users, with no differences in the proportion of the remaining White classes. Prepregnancy HbA1c was insignificantly lower in the CSII group, however, a significantly higher proportion of the CSII users reached the target value of HbA1c (P = 0.008). A prepregnancy daily dose of insulin (both total and per kg of body weight), body weight, and body mass index (BMI) did not differ between the groups. The 1st and 2nd trimester HbA1c was lower among the CSII users (6.83 ± 1.38 vs 7.52 ± 2.11%, P = 0.01 and 6.17 ± 0.9 vs 6.57 ± 1.12%, P = 0.009, respectively), while the 3rd trimester HbA1c as well as the total change in HbA1c were comparable. Neither DDI and body weight in concecutive trimesters, nor their total gestational increase, differed between the groups. The rate of pregnancy loss, such as abortions, fetal and neonatal death did not differ between the groups. As regards composite pregnancy loss, prepregnancy HbA1c was 8.41%±2.81% among the MDI cohort vs 7.22%±1.31% in the CSII users (P = 0.517). No differences were found in the gestational age at delivery, the mode of delivery, neonatal birth weight, the rate of macrosomy, LGA or SGA. A higher Apgar score was noted among the CSII users (8.63 ± 1.63 vs 8.03 ± 2.49%, P = 0.047), however, the proportion of neonates with an Apgar score lower than 7 points was similar. In the women planning pregnancy, as compared to the subjects who did not, HbA1c was significantly lower in the 1st trimester, together with a significantly higher rate of the women achieving the target HbA1c value during planning as well as in the 1st trimester. In the group of women planning pregnancy, significantly lower 1st trimester HbA1c and composite outcome of pregnancy loss were observed in the CSII users vs the MDI treated women. Lack of pregnancy planning and a high HbA1c level in the 1st trimester were independent predictors of both LGA (OR = 4.99 [95%CI 1.12-21.0], P = 0.033 and OR = 3.02 [95%CI 1.19-7.65], P = 0.019, respectively) and macrosomia (OR = 8.43 [95%CI 1.36-51.93], P = 0.021 and OR = 5.47 [95%CI 1.77-16.87], P = 0.003, respectively). CONCLUSIONS:The course of pregnancy and obstetric outcomes were not dependent on the mode of insulin delivery, but only on pregnancy planning and HbA1c in early pregnancy. Further studies are needed to explore more precise parameters describing both glycemic control in pregnant women as well as perinatal infant well-being.
journal_name
Diabetes Res Clin Practjournal_title
Diabetes research and clinical practiceauthors
Żurawska-Kliś M,Kosiński M,Kuchnicka A,Rurka M,Hałucha J,Wójcik M,Cypryk Kdoi
10.1016/j.diabres.2020.108628subject
Has Abstractpub_date
2020-12-22 00:00:00pages
108628eissn
0168-8227issn
1872-8227pii
S0168-8227(20)30885-8journal_volume
172pub_type
杂志文章abstract:AIMS:We evaluated whether glucose fluctuation (GF) causes vascular endothelial injury and affects glucometabolic factors during lengthy oral glucose tolerance test (OGTT). METHODS:We enrolled consecutive 116 patients with coronary artery disease (CAD) who were performed coronary angiography and 4-h OGTT. Blood samples...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/j.diabres.2017.07.007
更新日期:2017-09-01 00:00:00
abstract::The current study evaluates the indices of glucose control for diabetics (i.e., glycated albumin (GA), hemoglobin A1c (HbA1c), plasma glucose (PG) and immuno-reactive insulin (IRI)) in non-diabetic children from a population-based cohort, and compares those values according to the presence of obesity to examine any di...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/j.diabres.2005.07.008
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND:Type 1 Diabetes Mellitus (T1DM) patients among the children have been increasing rapidly in the recent years in Saudi Arabia, as a result there is a need for extensive research in this area. Various suggestions were kept forward including m-health technologies, telemedicine etc. However, very little research...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/j.diabres.2016.08.015
更新日期:2016-10-01 00:00:00
abstract::The effect of insulin on the serum levels of the amino-terminal propeptide of type III procollagen (PIIINP) was investigated in patients with non-insulin-dependent diabetes mellitus, whose disease was unsatisfactorily controlled by oral drugs. Before insulin therapy the PIIINP values of the patients (3.2 +/- 1.3 micro...
journal_title:Diabetes research and clinical practice
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0168-8227(92)90096-a
更新日期:1992-09-01 00:00:00
abstract:OBJECTIVE:To investigate infection-related mortality and its predictors in Brazilian type 2 diabetic patients. METHODS:It was carried out a long-term prospective study with 471 type 2 diabetic outpatients. Several clinical, laboratory and electrocardiographic variables were recorded at baseline. Predictive factors for...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/j.diabres.2006.04.008
更新日期:2007-01-01 00:00:00
abstract:AIM:The association between thyroid stimulating hormone (TSH) and type 2 diabetes mellitus (T2DM) is well known. However, whether TSH is related to diabetic peripheral neuropathy (DPN) has not been studied. The aim of this study was to explore the relationship between TSH and DPN in Chinese patients with T2DM. METHODS...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/j.diabres.2016.01.018
更新日期:2016-05-01 00:00:00
abstract::Chronic renal diseases, including diabetic nephropathy, evolve to terminal renal failure by a process leading to progressive parenchimal damage which appears relatively independent of the initial insult. When glomerular permselectivity is lost, proteins filtered through the glomerular capillary, through proximal tubul...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章,评审
doi:10.1016/s0168-8227(98)00016-3
更新日期:1998-04-01 00:00:00
abstract::Increased erythrocyte (RBC) sodium-lithium (Na-Li) counter transport (CT) has been reported to be a genetic marker for essential hypertension (EHT). In addition, increased RBC Na-Li CT has been demonstrated in insulin-dependent diabetic (IDDM) patients with nephropathy, indicating that a predisposition to hypertension...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/0168-8227(96)01206-5
更新日期:1996-03-01 00:00:00
abstract:AIMS:To compare the estimates and projections of type 2 diabetes mellitus (T2DM) prevalence in Saudi Arabia from a validated Markov model against other modelling estimates, such as those produced by the International Diabetes Federation (IDF) Diabetes Atlas and the Global Burden of Disease (GBD) project. METHODS:A dis...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/j.diabres.2013.12.036
更新日期:2014-03-01 00:00:00
abstract:AIMS:To evaluate whether progressively higher fasting plasma glucose (FPG) is associated to thickening of the interventricular septum (IVS) among non-diabetic subjects with obesity. METHODOLOGY:We studied 227 consecutive non diabetic patients (155 women and 72 men, age range 18-72 years) with overweight or obesity (BM...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/j.diabres.2020.108436
更新日期:2020-11-01 00:00:00
abstract::Considering the nervous system as a unit, it might be expected that diabetic patients with autonomic neuropathy could have a central abnormality expressed as cognitive dysfunction. To determine whether autonomic neuropathy is independently associated with cognitive dysfunction, we studied a cross-section of 20 non-ins...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/0168-8227(95)01150-1
更新日期:1995-11-01 00:00:00
abstract:BACKGROUND:This longitudinal study examined whether diabetes-specific family conflict and glycemic control were impacted/explained by negative affective responses to blood glucose checks (Negative BGM Affect). METHOD:Adolescents (N=150, ages 13-18 years) with type 1 diabetes, and their caregivers, completed measures o...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/j.diabres.2011.12.020
更新日期:2013-02-01 00:00:00
abstract::The purpose of this paper was to examine the relationship between fasting glucose levels and development of diabetes among residents of Penghu, Taiwan. From July 1995 to June 1996, a population-based cohort study was conducted among residents aged >or=40 years on the island of Penghu, Taiwan. Of the 1601 surveyed, 130...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/s0168-8227(03)00037-8
更新日期:2003-06-01 00:00:00
abstract::The effects of glucose (16.7 mM), potassium (50 mM), forskolin (20 microM), dibutyryl cyclic AMP (1 mM) and arachidonic acid (82 microM) upon insulin release and cytosolic free calcium concentrations ([Ca2+]i) were investigated in normal rat pancreatic islets. Potassium, forskolin and dibutyryl cyclic AMP significantl...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/s0168-8227(87)80053-0
更新日期:1987-09-01 00:00:00
abstract::The aim of this study was to determine the 10-year mortality rate of an elderly population aged 70 years or over (n=379) with reference to glucose tolerance status, taking into account other determinants of excess mortality. The baseline examination during 1991-1992 included a postal questionnaire, a physical examinat...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/j.diabres.2004.11.004
更新日期:2005-07-01 00:00:00
abstract::The issue of the peripheral resistance to insulin action has been getting a lot of attention over the last decade. The reason for this is that insulin is a major regulatory hormone and is involved in the metabolism of carbohydrates, lipids, protein and ions. To understand the pathophysiology of insulin resistance it i...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章,评审
doi:10.1016/0168-8227(89)90098-3
更新日期:1989-08-01 00:00:00
abstract:OBJECTIVE:To investigate association of psychosocial factors with anxiety and depressive symptoms in Chinese type 2 diabetes patients. METHODS:Three hundred and four type 2 diabetes patients were inquired with a structured questionnaire about socio-demographic characteristics, psychological stress, coping styles, soci...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/j.diabres.2007.10.014
更新日期:2008-03-01 00:00:00
abstract:AIMS:To study the influence of the quantity and the quality of carbohydrate consumption on glycemic control in early pregnancy among women with type 1 diabetes. METHODS:A retrospective study of 107 women with type 1 diabetes who completed 1-3days of diet recording before first antenatal visit, as a part of routine car...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/j.diabres.2016.12.012
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:To evaluate the efficacy of continuous glucose monitoring system (CGMS) to detect postprandial hyperglycemia and unrecognized hypoglycemia in type 1 diabetes mellitus (DM1) patients. METHODS:We studied 46 patients (43.4%M/56.6%F), average age of 25.9+/-12.8 years, submitted to 72 h CGMS. It were analyzed: c...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/j.diabres.2006.05.009
更新日期:2007-01-01 00:00:00
abstract::This study was done to see whether 27-base pair repeats polymorphism in intron 4 of ecNOS gene is associated with carotid atherosclerosis in type 2 diabetic patients. The polymorphism was identified by polymerase chain reaction (PCR). Ultrasound parameters of carotid atherosclerosis were analyzed in relation to the ge...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/j.diabres.2005.11.002
更新日期:2006-06-01 00:00:00
abstract::Our aim was to see the levels of lipoprotein (a) (Lp (a)) in patients with gangrenous or non-gangrenous diabetic foot lesions. Twenty-two patients with gangrenous foot lesions, 11 with non-gangrenous foot lesions and 10 healthy subjects were included in the study. All the patients had similar glycemic control and dura...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/j.diabres.2005.06.005
更新日期:2006-02-01 00:00:00
abstract:AIM:Studies on the effect of Ramadan diurnal intermittent fasting (RDIF) on glucometabolic markers have yielded conflicting results. We conducted ameta-analysis to estimate the effect size for changes in glucometabolic markers in healthy, non-athletic Muslims during Ramadan, and to assess the effect of variable covaria...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章,meta分析
doi:10.1016/j.diabres.2020.108226
更新日期:2020-07-01 00:00:00
abstract::GM and KM immunoglobulin allotypes, which are the markers, respectively, of the constant parts of the heavy and the light chains of the IgG1, IgG2 and IgG3 subclasses, have been analysed in diabetic mellitus patients and controls living in New Caledonia. We tested 40 Europeans, 256 Melanesians and 44 Polynesians, as w...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/s0168-8227(99)00125-4
更新日期:2000-03-01 00:00:00
abstract:AIMS:To evaluate the risk of gestational diabetes (GDM) and of neonatal/maternal complications (macrosomia, large for gestational age (LGA), cesarean sections, preterm deliveries, neonatal distress and fetal malformations) among women coming from High Migration Pressure Countries (HMPC), compared to native (Italian) mo...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/j.diabres.2020.108128
更新日期:2020-05-01 00:00:00
abstract::We retrospectively analyzed the courses of 37 non-insulin dependent diabetics (hemodialyzed:HD group) with end-stage renal disease (ESRD), to identify factors predisposing to renal failure. The factors analyzed were: diabetic (non-proliferative and proliferative) retinopathy, family histories of diabetes and hypertens...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/0168-8227(95)01130-7
更新日期:1995-09-01 00:00:00
abstract::We investigated the preventive effects of ferulic acid (FA) and alpha-tocopherol (AT) on the progression of diabetic nephropathy. Otsuka Long-Evans Tokushima Fatty (OLETF) and Long-Evans Tokushima Otsuka (LETO) rats were used as type 2 diabetes and non-diabetes models, respectively. Two-thirds of the OLETF rats were f...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/j.diabres.2007.08.009
更新日期:2008-01-01 00:00:00
abstract::This study compared the relative role of insulin resistance and beta-cell dysfunction (both assessed using the HOMA method) with glucose intolerance conditions in the progression to type 2 diabetes among a high risk group of subjects with fasting plasma glucose (FPG) 5.6-7.0 mmol/l in Kinmen, Taiwan. Data were collect...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/s0168-8227(02)00249-8
更新日期:2003-03-01 00:00:00
abstract:AIMS:To investigate the clinical characteristics, laboratory findings and high- resolution CT (HRCT) features and to explore the risk factors for in-hospital death and complications of coronavirus disease 2019 (COVID-19) patients with diabetes. METHODS:From Dec 31, 2019, to Apr 5, 2020, a total of 132 laboratory-confi...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/j.diabres.2020.108299
更新日期:2020-08-01 00:00:00
abstract::The influence of xenogeneic islet cell surface antibodies (ICSA) on the hormonal secretion of non-B islet cells has not been completely elucidated. Accordingly, we investigated the influence of xenogeneic antiserum on glucagon release from A cells, as representative of non-B islet cells, together with other characteri...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/s0168-8227(87)80020-7
更新日期:1987-05-01 00:00:00
abstract:AIMS:Reusing insulin pen needles could help to reduce the increasing economic burden of diabetes. We tested the hypothesis that reusing insulin pen needles leads to needle tip deformity and increased pain. METHODS:Three blinded reviewers assessed 123 electron microscope pictures analyzing needle tip deformity of insul...
journal_title:Diabetes research and clinical practice
pub_type: 杂志文章
doi:10.1016/j.diabres.2004.06.001
更新日期:2005-02-01 00:00:00