Type 1 diabetes woman with repeated miscarriages successfully gave birth after introducing an insulin pump with a predictive low glucose suspend feature
Type 1 diabetes woman with repeated miscarriages successfully gave birth after introducing an insulin pump with a predictive low glucose suspend feature
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DOI：
10.1007/s13340-020-00489-9
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发表时间：
2021-03-06
影响因子：
2.2
通讯作者：
Tobe, Kazuyuki
中科院分区：
文献类型：
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作者：
Honoki, Hisae;Yagi, Kunimasa;Tobe, Kazuyuki
具有预测性低血糖暂停（SAP-PLGS）功能的传感器增强胰岛素泵治疗是1型糖尿病患者血糖管理的一种显著进步的模式。该技术可避免夜间低血糖和严重低血糖。一名巴西妇女在11岁时患上了1型糖尿病，并接受了每日多次胰岛素注射治疗。20岁时，她第一次怀孕住进了我们的内科。妊娠6周时，HbA 1c为7.9%。尽管采用了持续皮下胰岛素输注和传感器增强泵的组合，但她在下周流产。6个月后，她再次怀孕。尽管HbA 1c为7.2%，但她再次流产。此后，她恢复了每日多次胰岛素注射，并开始使用间歇扫描连续血糖监测。22岁时，她第三次怀孕。HbA 1c为7.3%。然后引入SAP-PLGS，这减少了她频繁的低血糖事件和血糖波动。她在39周时产下了一个4137 g的男孩，没有明显的并发症。1型糖尿病妇女在使用SAP-PLGS后反复流产，可成功分娩。我们推测，该模式可能有助于我们的病人的流产避免减少她的血糖波动。
Sensor-augmented insulin pump therapy with a predictive low glucose suspend (SAP-PLGS) feature is a remarkably progressed modality for the glycemic management of patients with type 1 diabetes. This technology avoids nocturnal hypoglycemia and severe hypoglycemia. A Brazilian woman developed type 1 diabetes at age 11 and was treated with multiple daily insulin injections. At age 20, she was admitted to our internal medicine department for her first pregnancy. Her HbA1c was 7.9% in the 6 weeks of gestation. Although the combination of continuous subcutaneous insulin infusion and a sensor-augmented pump was introduced, she had a miscarriage in the next week. After 6 months, she became pregnant again. Despite an HbA1c of 7.2%, she had another miscarriage. Thereafter, she returned to multiple daily insulin injections and began using intermittently scanned continuous glycemic monitoring. At age 22, she had her third pregnancy. Her HbA1c was 7.3%. SAP-PLGS was then introduced, which reduced her frequent hypoglycemic events and blood glucose fluctuations. She gave birth to a 4137 g boy at 39 weeks without significant complications. Successful delivery can be obtained in women with type 1 diabetes following repeated miscarriages after introducing SAP-PLGS. We hypothesize that the modality might contributed to our patient's miscarriage avoidance by reducing her glycemic fluctuations.