Comparative effects of insulin pump and injection on gestational diabetes mellitus pregnancy outcomes and serum biomarkers

Abstract

BACKGROUND

Insulin injection is the basic daily drug treatment for diabetic patients.

AIM

To evaluate the comparative impacts of continuous subcutaneous insulin infusion (CSII).

METHODS

Based on the treatment modality received, the patients were allocated into two cohorts: The CSII group and the multiple daily injections (MDI) group, with each cohort comprising 210 patients. Comparative assessments were made regarding serum levels of serum-secreted frizzled-related protein 5, homocysteine, and C1q/TNF-related protein 9. Furthermore, outcomes such as fasting plasma glucose, 2-hour postprandial glucose levels, pain assessment scores, and the incidence of complications were evaluated post-treatment.

RESULTS

The CSII group displayed notably lower fasting plasma glucose and 2-h postprandial glucose levels in comparison to the MDI group (P < 0.05). Subsequent analysis post-treatment unveiled a significantly higher percentage of patients reporting no pain in the CSII group (60.00%) in contrast to the MDI group (36.19%) (P < 0.05). Additionally, the CSII group exhibited a markedly reduced occurrence of fetal distress and premature rupture of membranes compared to the MDI group (P < 0.05). However, there were no significant variances observed in other pregnancy outcomes between the two groups (P > 0.05). A statistical analysis revealed a significant difference in the incidence of complications between the groups (χ² = 11.631, P = 0.001).

CONCLUSION

The utilization of CSII via an insulin pump, as opposed to MDI, can significantly enhance the management of insulin administration in patients with GDM by diversifying the sites of insulin delivery. This approach not only promotes optimal glycemic control but also regulates metabolic factors linked to blood sugar, reducing the likelihood of adverse pregnancy outcomes and complications. The clinical relevance and importance of CSII in GDM management highlight its wide-ranging clinical usefulness.

Keywords: Continuous subcutaneous insulin infusion; Multiple daily injections; Gestational diabetes mellitus; Pregnancy outcome; Serum biomarkers

Core Tip: This study delineates the comparative efficacy of continuous subcutaneous insulin infusion (CSII) via insulin pumps and multiple daily injections in managing gestational diabetes mellitus (GDM), focusing on pregnancy outcomes and serum biomarkers. It reveals CSII's superior capability in enhancing glycemic control, reducing pain, and decreasing the incidence of fetal distress and premature rupture of membranes, without significantly altering other pregnancy outcomes. Highlighting the novel insight into CSII's role in modulating key metabolic biomarkers, this research contributes to optimizing GDM management strategies, offering a significant leap towards personalized diabetic care in pregnancy.