Diabetes Care | 2019
Dietary Patterns of Insulin Pump and Multiple Daily Injection Users During Type 1 Diabetes Pregnancy
Abstract
Insulin pump therapy offers theoretical advantages over multiple daily injections (MDI) for fine-tuning insulin dose adjustment. However, evidence regarding the effectiveness of pump compared with MDI on glycemic control during pregnancy is conflicting. The Continuous Glucose Monitoring in Women With Type 1 Diabetes in Pregnancy Trial (CONCEPTT) was a randomized trial of continuous glucose monitoring (CGM) before and during pregnancy (1). A secondary analysis found that pregnant women using pumps had suboptimal midgestation glycemic control compared with women using MDI (2). CGM measures demonstrated comparable time in range (TIR) 63–140 mg/dL at 12 and 34 weeks but 5% lower TIR in pump users at 24 weeks (48% vs. 53%), meaning that pump users spent, on average, 1 h 15 min per day less time in the glucose target range.\n\nThere are several potential explanations for this, including baseline differences in women using pump or MDI, differences in insulin dose adjustment, and differences in dietary intake. Women using pumps have more dietary flexibility with no additional injections required for snacks. Through the use of prospectively collected dietary data from U.K. and Irish CONCEPTT participants, our objective was to examine the dietary patterns of women using insulin pumps and MDI during pregnancy.\n\nDetails of the main CONCEPTT, pump versus MDI, and diet studies were previously published (1–3). All U.K. participants ( n = 113) were invited to participate in the CONCEPTT diet …