Glycemic control and maternal and fetal outcomes in pregnant women with type 1 diabetes according to the type of basal insulin
Abstract Objective To examine the potential role of the type of basal insulin on glycemic control and maternal and foetal outcomes in pregnant women with type 1 diabetes (T1DM). Study design Retrospective cohort study of pregnancies attended at 18 Spanish tertiary hospitals. Inclusion criteria T1DM,...
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| Veröffentlicht in: | European journal of obstetrics & gynecology and reproductive biology 2016-11, Vol.206, p.84-91 |
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| creator | Chico, A Herranz, L Corcoy, R Ramírez, O Goya, M.M Bellart, J González-Romero, S Codina, M Sánchez, P Cortázar, A Acosta, D Picón, M.J Rubio, J.A Megía, A Sancho, M.A Balsells, M Solá, E González, N.L López-López, J |
| description | Abstract Objective To examine the potential role of the type of basal insulin on glycemic control and maternal and foetal outcomes in pregnant women with type 1 diabetes (T1DM). Study design Retrospective cohort study of pregnancies attended at 18 Spanish tertiary hospitals. Inclusion criteria T1DM, singleton pregnancies, delivery between 2002–2010, and use of the same basal and prandial insulin from before pregnancy until delivery. Results A total of 1534 pregnancies were included. The basal insulin most commonly used was Neutral Protamine Hagedorn (NPH) (51.7%), followed by glargine (23.2%) and continuous subcutaneous insulin infusion (CSII) (21.1%). CSII users had longer diabetes duration. Multiple logistic regression analysis showed that CSII was independently associated with lower doses of insulin, higher glycated haemoglobin (HbA1c ) in all trimesters, and higher rates of miscarriage, preterm birth and neonatal hypoglycemia. Glargine was related to a higher risk of preterm birth and a small-for-gestational age infant (SGA). The odds ratios (OR) of the associations between insulin type and clinical outcomes (from 0.642 to 4.894) have a relevant magnitude. Conclusions In this observational study of pregnant women with T1DM, the type of basal insulin was independently associated with metabolic variables and foetal outcomes. |
| doi_str_mv | 10.1016/j.ejogrb.2016.07.490 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1837023764</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S030121151630817X</els_id><sourcerecordid>1837023764</sourcerecordid><originalsourceid>FETCH-LOGICAL-c463t-735a474ca11c78cf9711cf5d374c28da94be543bbaac58d69f750b5c40243da33</originalsourceid><addsrcrecordid>eNqFkUGP1SAQx4nRuM_Vb2AMRy-tUCi0FxOzWVeTTTyoiTdCYfqW2sITqJt38bNL09WDF7kwM_nNfzL_QeglJTUlVLyZapjCMQ51U7KayJr35BE60E42lRQtf4wOhBFaNZS2F-hZShMpj7H-KbpopGC9IOKAft3MZwOLM9gEn2OYsfYWLzpD9HpPRsglCms2YYGEncenCEevfcb3peLxvct3OJ9PgCm2Tg-QC6aNCdE6f8Q54HwHOxBGPOhU5JxP6-z8c_Rk1HOCFw__Jfr6_vrL1Yfq9tPNx6t3t5XhguVKslZzyY2m1MjOjL0swdhaVmpNZ3XPB2g5GwatTdtZ0Y-yJUNrOGk4s5qxS_R61z3F8GOFlNXikoF51h7CmhTtmCQNk4IXlO-oiSGlCKM6RbfoeFaUqM15NandebU5r4hUxfnS9uphwjosYP82_bG6AG93AMqePx1ElYwDb8C6CCYrG9z_JvwrYIqDzuj5O5whTWHdTlZ2UalRRH3err8dnwpGOiq_sd9AUKzy</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1837023764</pqid></control><display><type>article</type><title>Glycemic control and maternal and fetal outcomes in pregnant women with type 1 diabetes according to the type of basal insulin</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><creator>Chico, A ; Herranz, L ; Corcoy, R ; Ramírez, O ; Goya, M.M ; Bellart, J ; González-Romero, S ; Codina, M ; Sánchez, P ; Cortázar, A ; Acosta, D ; Picón, M.J ; Rubio, J.A ; Megía, A ; Sancho, M.A ; Balsells, M ; Solá, E ; González, N.L ; López-López, J</creator><creatorcontrib>Chico, A ; Herranz, L ; Corcoy, R ; Ramírez, O ; Goya, M.M ; Bellart, J ; González-Romero, S ; Codina, M ; Sánchez, P ; Cortázar, A ; Acosta, D ; Picón, M.J ; Rubio, J.A ; Megía, A ; Sancho, M.A ; Balsells, M ; Solá, E ; González, N.L ; López-López, J ; the GEDE (Group of Diabetes and Pregnancy of the Spanish Diabetes Association) ; GEDE (Group of Diabetes and Pregnancy of the Spanish Diabetes Association)</creatorcontrib><description>Abstract Objective To examine the potential role of the type of basal insulin on glycemic control and maternal and foetal outcomes in pregnant women with type 1 diabetes (T1DM). Study design Retrospective cohort study of pregnancies attended at 18 Spanish tertiary hospitals. Inclusion criteria T1DM, singleton pregnancies, delivery between 2002–2010, and use of the same basal and prandial insulin from before pregnancy until delivery. Results A total of 1534 pregnancies were included. The basal insulin most commonly used was Neutral Protamine Hagedorn (NPH) (51.7%), followed by glargine (23.2%) and continuous subcutaneous insulin infusion (CSII) (21.1%). CSII users had longer diabetes duration. Multiple logistic regression analysis showed that CSII was independently associated with lower doses of insulin, higher glycated haemoglobin (HbA1c ) in all trimesters, and higher rates of miscarriage, preterm birth and neonatal hypoglycemia. Glargine was related to a higher risk of preterm birth and a small-for-gestational age infant (SGA). The odds ratios (OR) of the associations between insulin type and clinical outcomes (from 0.642 to 4.894) have a relevant magnitude. Conclusions In this observational study of pregnant women with T1DM, the type of basal insulin was independently associated with metabolic variables and foetal outcomes.</description><identifier>ISSN: 0301-2115</identifier><identifier>EISSN: 1872-7654</identifier><identifier>DOI: 10.1016/j.ejogrb.2016.07.490</identifier><identifier>PMID: 27639606</identifier><language>eng</language><publisher>Ireland: Elsevier B.V</publisher><subject>Adult ; Blood Glucose ; Continuous subcutaneous insulin infusion ; Diabetes Mellitus, Type 1 - blood ; Diabetes Mellitus, Type 1 - diet therapy ; Female ; Glycated haemoglobin ; Glycated Hemoglobin A - analysis ; Humans ; Hypoglycemic Agents - therapeutic use ; Infant, Newborn ; Insulin - therapeutic use ; Insulin analogue ; Male ; Obstetrics and Gynecology ; Perinatal outcomes ; Pregnancy ; Pregnancy in Diabetics ; Pregnancy Outcome ; Retrospective Studies ; Type 1 diabetes</subject><ispartof>European journal of obstetrics & gynecology and reproductive biology, 2016-11, Vol.206, p.84-91</ispartof><rights>Elsevier Ireland Ltd</rights><rights>2016 Elsevier Ireland Ltd</rights><rights>Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c463t-735a474ca11c78cf9711cf5d374c28da94be543bbaac58d69f750b5c40243da33</citedby><cites>FETCH-LOGICAL-c463t-735a474ca11c78cf9711cf5d374c28da94be543bbaac58d69f750b5c40243da33</cites><orcidid>0000-0001-7673-5239</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ejogrb.2016.07.490$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27639606$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chico, A</creatorcontrib><creatorcontrib>Herranz, L</creatorcontrib><creatorcontrib>Corcoy, R</creatorcontrib><creatorcontrib>Ramírez, O</creatorcontrib><creatorcontrib>Goya, M.M</creatorcontrib><creatorcontrib>Bellart, J</creatorcontrib><creatorcontrib>González-Romero, S</creatorcontrib><creatorcontrib>Codina, M</creatorcontrib><creatorcontrib>Sánchez, P</creatorcontrib><creatorcontrib>Cortázar, A</creatorcontrib><creatorcontrib>Acosta, D</creatorcontrib><creatorcontrib>Picón, M.J</creatorcontrib><creatorcontrib>Rubio, J.A</creatorcontrib><creatorcontrib>Megía, A</creatorcontrib><creatorcontrib>Sancho, M.A</creatorcontrib><creatorcontrib>Balsells, M</creatorcontrib><creatorcontrib>Solá, E</creatorcontrib><creatorcontrib>González, N.L</creatorcontrib><creatorcontrib>López-López, J</creatorcontrib><creatorcontrib>the GEDE (Group of Diabetes and Pregnancy of the Spanish Diabetes Association)</creatorcontrib><creatorcontrib>GEDE (Group of Diabetes and Pregnancy of the Spanish Diabetes Association)</creatorcontrib><title>Glycemic control and maternal and fetal outcomes in pregnant women with type 1 diabetes according to the type of basal insulin</title><title>European journal of obstetrics & gynecology and reproductive biology</title><addtitle>Eur J Obstet Gynecol Reprod Biol</addtitle><description>Abstract Objective To examine the potential role of the type of basal insulin on glycemic control and maternal and foetal outcomes in pregnant women with type 1 diabetes (T1DM). Study design Retrospective cohort study of pregnancies attended at 18 Spanish tertiary hospitals. Inclusion criteria T1DM, singleton pregnancies, delivery between 2002–2010, and use of the same basal and prandial insulin from before pregnancy until delivery. Results A total of 1534 pregnancies were included. The basal insulin most commonly used was Neutral Protamine Hagedorn (NPH) (51.7%), followed by glargine (23.2%) and continuous subcutaneous insulin infusion (CSII) (21.1%). CSII users had longer diabetes duration. Multiple logistic regression analysis showed that CSII was independently associated with lower doses of insulin, higher glycated haemoglobin (HbA1c ) in all trimesters, and higher rates of miscarriage, preterm birth and neonatal hypoglycemia. Glargine was related to a higher risk of preterm birth and a small-for-gestational age infant (SGA). The odds ratios (OR) of the associations between insulin type and clinical outcomes (from 0.642 to 4.894) have a relevant magnitude. Conclusions In this observational study of pregnant women with T1DM, the type of basal insulin was independently associated with metabolic variables and foetal outcomes.</description><subject>Adult</subject><subject>Blood Glucose</subject><subject>Continuous subcutaneous insulin infusion</subject><subject>Diabetes Mellitus, Type 1 - blood</subject><subject>Diabetes Mellitus, Type 1 - diet therapy</subject><subject>Female</subject><subject>Glycated haemoglobin</subject><subject>Glycated Hemoglobin A - analysis</subject><subject>Humans</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>Infant, Newborn</subject><subject>Insulin - therapeutic use</subject><subject>Insulin analogue</subject><subject>Male</subject><subject>Obstetrics and Gynecology</subject><subject>Perinatal outcomes</subject><subject>Pregnancy</subject><subject>Pregnancy in Diabetics</subject><subject>Pregnancy Outcome</subject><subject>Retrospective Studies</subject><subject>Type 1 diabetes</subject><issn>0301-2115</issn><issn>1872-7654</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUGP1SAQx4nRuM_Vb2AMRy-tUCi0FxOzWVeTTTyoiTdCYfqW2sITqJt38bNL09WDF7kwM_nNfzL_QeglJTUlVLyZapjCMQ51U7KayJr35BE60E42lRQtf4wOhBFaNZS2F-hZShMpj7H-KbpopGC9IOKAft3MZwOLM9gEn2OYsfYWLzpD9HpPRsglCms2YYGEncenCEevfcb3peLxvct3OJ9PgCm2Tg-QC6aNCdE6f8Q54HwHOxBGPOhU5JxP6-z8c_Rk1HOCFw__Jfr6_vrL1Yfq9tPNx6t3t5XhguVKslZzyY2m1MjOjL0swdhaVmpNZ3XPB2g5GwatTdtZ0Y-yJUNrOGk4s5qxS_R61z3F8GOFlNXikoF51h7CmhTtmCQNk4IXlO-oiSGlCKM6RbfoeFaUqM15NandebU5r4hUxfnS9uphwjosYP82_bG6AG93AMqePx1ElYwDb8C6CCYrG9z_JvwrYIqDzuj5O5whTWHdTlZ2UalRRH3err8dnwpGOiq_sd9AUKzy</recordid><startdate>20161101</startdate><enddate>20161101</enddate><creator>Chico, A</creator><creator>Herranz, L</creator><creator>Corcoy, R</creator><creator>Ramírez, O</creator><creator>Goya, M.M</creator><creator>Bellart, J</creator><creator>González-Romero, S</creator><creator>Codina, M</creator><creator>Sánchez, P</creator><creator>Cortázar, A</creator><creator>Acosta, D</creator><creator>Picón, M.J</creator><creator>Rubio, J.A</creator><creator>Megía, A</creator><creator>Sancho, M.A</creator><creator>Balsells, M</creator><creator>Solá, E</creator><creator>González, N.L</creator><creator>López-López, J</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7673-5239</orcidid></search><sort><creationdate>20161101</creationdate><title>Glycemic control and maternal and fetal outcomes in pregnant women with type 1 diabetes according to the type of basal insulin</title><author>Chico, A ; Herranz, L ; Corcoy, R ; Ramírez, O ; Goya, M.M ; Bellart, J ; González-Romero, S ; Codina, M ; Sánchez, P ; Cortázar, A ; Acosta, D ; Picón, M.J ; Rubio, J.A ; Megía, A ; Sancho, M.A ; Balsells, M ; Solá, E ; González, N.L ; López-López, J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c463t-735a474ca11c78cf9711cf5d374c28da94be543bbaac58d69f750b5c40243da33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Blood Glucose</topic><topic>Continuous subcutaneous insulin infusion</topic><topic>Diabetes Mellitus, Type 1 - blood</topic><topic>Diabetes Mellitus, Type 1 - diet therapy</topic><topic>Female</topic><topic>Glycated haemoglobin</topic><topic>Glycated Hemoglobin A - analysis</topic><topic>Humans</topic><topic>Hypoglycemic Agents - therapeutic use</topic><topic>Infant, Newborn</topic><topic>Insulin - therapeutic use</topic><topic>Insulin analogue</topic><topic>Male</topic><topic>Obstetrics and Gynecology</topic><topic>Perinatal outcomes</topic><topic>Pregnancy</topic><topic>Pregnancy in Diabetics</topic><topic>Pregnancy Outcome</topic><topic>Retrospective Studies</topic><topic>Type 1 diabetes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chico, A</creatorcontrib><creatorcontrib>Herranz, L</creatorcontrib><creatorcontrib>Corcoy, R</creatorcontrib><creatorcontrib>Ramírez, O</creatorcontrib><creatorcontrib>Goya, M.M</creatorcontrib><creatorcontrib>Bellart, J</creatorcontrib><creatorcontrib>González-Romero, S</creatorcontrib><creatorcontrib>Codina, M</creatorcontrib><creatorcontrib>Sánchez, P</creatorcontrib><creatorcontrib>Cortázar, A</creatorcontrib><creatorcontrib>Acosta, D</creatorcontrib><creatorcontrib>Picón, M.J</creatorcontrib><creatorcontrib>Rubio, J.A</creatorcontrib><creatorcontrib>Megía, A</creatorcontrib><creatorcontrib>Sancho, M.A</creatorcontrib><creatorcontrib>Balsells, M</creatorcontrib><creatorcontrib>Solá, E</creatorcontrib><creatorcontrib>González, N.L</creatorcontrib><creatorcontrib>López-López, J</creatorcontrib><creatorcontrib>the GEDE (Group of Diabetes and Pregnancy of the Spanish Diabetes Association)</creatorcontrib><creatorcontrib>GEDE (Group of Diabetes and Pregnancy of the Spanish Diabetes Association)</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of obstetrics & gynecology and reproductive biology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chico, A</au><au>Herranz, L</au><au>Corcoy, R</au><au>Ramírez, O</au><au>Goya, M.M</au><au>Bellart, J</au><au>González-Romero, S</au><au>Codina, M</au><au>Sánchez, P</au><au>Cortázar, A</au><au>Acosta, D</au><au>Picón, M.J</au><au>Rubio, J.A</au><au>Megía, A</au><au>Sancho, M.A</au><au>Balsells, M</au><au>Solá, E</au><au>González, N.L</au><au>López-López, J</au><aucorp>the GEDE (Group of Diabetes and Pregnancy of the Spanish Diabetes Association)</aucorp><aucorp>GEDE (Group of Diabetes and Pregnancy of the Spanish Diabetes Association)</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Glycemic control and maternal and fetal outcomes in pregnant women with type 1 diabetes according to the type of basal insulin</atitle><jtitle>European journal of obstetrics & gynecology and reproductive biology</jtitle><addtitle>Eur J Obstet Gynecol Reprod Biol</addtitle><date>2016-11-01</date><risdate>2016</risdate><volume>206</volume><spage>84</spage><epage>91</epage><pages>84-91</pages><issn>0301-2115</issn><eissn>1872-7654</eissn><abstract>Abstract Objective To examine the potential role of the type of basal insulin on glycemic control and maternal and foetal outcomes in pregnant women with type 1 diabetes (T1DM). Study design Retrospective cohort study of pregnancies attended at 18 Spanish tertiary hospitals. Inclusion criteria T1DM, singleton pregnancies, delivery between 2002–2010, and use of the same basal and prandial insulin from before pregnancy until delivery. Results A total of 1534 pregnancies were included. The basal insulin most commonly used was Neutral Protamine Hagedorn (NPH) (51.7%), followed by glargine (23.2%) and continuous subcutaneous insulin infusion (CSII) (21.1%). CSII users had longer diabetes duration. Multiple logistic regression analysis showed that CSII was independently associated with lower doses of insulin, higher glycated haemoglobin (HbA1c ) in all trimesters, and higher rates of miscarriage, preterm birth and neonatal hypoglycemia. Glargine was related to a higher risk of preterm birth and a small-for-gestational age infant (SGA). The odds ratios (OR) of the associations between insulin type and clinical outcomes (from 0.642 to 4.894) have a relevant magnitude. Conclusions In this observational study of pregnant women with T1DM, the type of basal insulin was independently associated with metabolic variables and foetal outcomes.</abstract><cop>Ireland</cop><pub>Elsevier B.V</pub><pmid>27639606</pmid><doi>10.1016/j.ejogrb.2016.07.490</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-7673-5239</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | European journal of obstetrics & gynecology and reproductive biology, 2016-11, Vol.206, p.84-91 |
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| subjects | Adult Blood Glucose Continuous subcutaneous insulin infusion Diabetes Mellitus, Type 1 - blood Diabetes Mellitus, Type 1 - diet therapy Female Glycated haemoglobin Glycated Hemoglobin A - analysis Humans Hypoglycemic Agents - therapeutic use Infant, Newborn Insulin - therapeutic use Insulin analogue Male Obstetrics and Gynecology Perinatal outcomes Pregnancy Pregnancy in Diabetics Pregnancy Outcome Retrospective Studies Type 1 diabetes |
| title | Glycemic control and maternal and fetal outcomes in pregnant women with type 1 diabetes according to the type of basal insulin |
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