Insulin pumps or multiple daily injections to control type 1 diabetes in pregnancy

Our researchers have shown that giving multiple daily injections of insulin to control type 1 diabetes appears to be better than using insulin pumps, with the health of both mother and baby seeming to be improved.
  • Author's list

    Professor Helen Murphy, Dr Annette Briley, Dr Anita Banerjee

This study is now complete

There are two different ways that people with type 1 diabetes can take insulin to control their blood glucose levels – they can give themselves multiple daily injections of insulin or use an insulin pump.

Insulin pumps are electronic devices that deliver small amounts of insulin into the blood throughout the day and night. Outside of pregnancy, we know that insulin pumps generally help people control their blood glucose levels most effectively, with fewer highs and lows.

Controlling blood glucose levels

We do not know whether insulin pumps or multiple daily injections are the best way of controlling blood glucose levels in pregnant women with type 1 diabetes. To change this, we looked at the data we collected from 248 pregnant women who took part in the CONCEPTT study to see whether the way they gave themselves insulin led to any differences in outcomes.

We found that women who chose multiple daily injections of insulin controlled their blood glucose levels better, and also had fewer incidences of high blood pressure during pregnancy.

Outcomes were worse for the babies of the women who chose insulin pumps, with more of them having low blood sugar levels after birth or being admitted to a Neonatal Intensive Care Unit.

Insulin pumps may not be the best way of delivering insulin

Our results show that insulin pumps may not be the best way of treating pregnant women with type 1 diabetes.

However, it is important to mention that the women in our study, along with their clinicians, decided which method of insulin delivery they would use, and so it is possible that the women who used insulin pumps had a disease that was already harder to control. This could have affected our results.

We think that more research is needed to better understand whether insulin pumps should be used to control type 1 diabetes in pregnancy. One exciting development is the introduction of an automated way of giving patients the exact amount of insulin they need, using a continuous glucose monitor alongside an insulin pump and a computer program.

In a new study that will include over 100 women, we are going to test whether this automated method can help pregnant women to better control their type 1 diabetes and have a healthy pregnancy.

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