Chapter

CSII in pregnancy and pre-pregnancy

Peter Hammond

in Insulin Pump Therapy and Continuous Glucose Monitoring

Published on behalf of Oxford University Press

ISBN: 9780199568604
Published online May 2011 | e-ISBN: 9780199607440 | DOI: http://dx.doi.org/10.1093/med/9780199568604.003.0006

Series: Oxford Diabetes Library

CSII in pregnancy and pre-pregnancy

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• Continuous subcutaneous insulin infusion (CSII) should be considered as an alternative to multiple daily insulin injections (MDI), or when an individual on MDI has failed to achieve the tight glycaemic control desirable in diabetic pregnancy (HbA1c <6.1%) without causing problematic hypoglycaemia • The published literature is very limited in allowing comparison between CSII and MDI in pregnancy, although there is no evidence from randomized controlled trials for any superiority of CSII over MDI • CSII should be commenced pre-conceptually if possible, since optimized control is desirable before conception takes place • Intrapartum use of CSII has been shown to be more efficacious at controlling blood glucose levels at the time of delivery and this may reduce rates of neonatal hypoglycaemia • Combining CSII with continuous glucose monitoring (CGM) may allow better control to be obtained in the later stages of pregnancy and reduce the incidence of macrosomia, but further studies are needed to establish the potential of sensor-augmented pumps in this situation

Chapter.  3078 words. 

Subjects: Endocrinology and Diabetes

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