Type 1 diabetes woman with repeated miscarriages successfully gave birth after introducing an insulin pump with a predictive low glucose suspend feature

Hisae Honoki, Kunimasa Yagi*, Sayaka Tsuda, Tsutomu Wada, Asako Enkaku, Maki Nakagawa-Yokoyama, Miki Kamigishi, Masataka Shikata, Akiko Takikawa-Nishiday, Shiho Fujisaka, Daisuke Chujo, Toshiyasu Sasaoka, Akitoshi Nakashima, Shigeru Saito, Kazuyuki Tobe

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)324-329
Number of pages6
JournalDiabetology International
Volume12
Issue number3
DOIs
StatePublished - 2021/07

Keywords

  • Glycemic fluctuations
  • PLGS
  • Pregnancy
  • SAP
  • Type 1 diabetes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

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