Insulin pump, CGM use linked to better glucose control during pregnancy

The use of either an insulin pump or a continuous glucose monitoring (CGM) device among pregnant women with type 1 diabetes leads to improved glycaemic control, although pump use appears to be linked to higher birth weight measures, a study has found.

Researchers looked at the medical records of 646 pregnancies in 478 women with type 1 diabetes. They compared pregnancy-related outcomes among insulin pump users, multiple daily injection (MDI) users, and CGM users by applying mixed effect models.

Results showed that pump use produced reductions in lower HbA1c levels in the first (β, –0.33 percent, 95 percent confidence interval [CI], –0.51 to –0.15) and second trimester (β, –0.13 percent, 95 percent CI, –0.24 to –0.02).

However, insulin pump was also associated with increased birth weight (β, 0.14 kg, 95 percent CI, 0.02–0.26) and birth weight percentile (β, 4.87 percent, 95 percent CI, 0.49–9.26), as well as higher likelihood of large for gestational age (odds ratio [OR], 1.65, 95 percent CI, 1.06–2.58) and macrosomia (OR, 1.81, 95 percent CI, 1.03–3.18).

CGM use likewise led to lower HbA1c levels in the first (β, –0.38 percent, 95 percent CI, –0.64 to –0.13) and third trimester (β, –0.17 percent, 95 percent CI, –0.33 to –0.00).