A retrospective case-control study showed that pregnant women on diabetes, insulin pump therapy and multiple insulin injection therapy in glycemic control, maternal and perinatal health care costs and other effects and no significant differences in many aspects.
From the University of Washington Medical Center, Dr. Steven Gabbe and his colleagues on the insulin pump and multiple insulin injection treatment effects and costs were evaluated.
Since nearly 20 years since the invention of insulin pump therapy has been engaged in continuous improvement. The study was the current insulin pump therapy during pregnancy and the postpartum evaluation of the application, and observe the pump caused by treatment of low blood sugar level and increase the risk for ketoacidosis.
The authors found that in all three three-month treatment period, three groups of patients with glycosylated hemoglobin A level of no difference. And, for from an average of 16.8 months of pregnancy began to use insulin pump therapy in pregnant women, blood glucose control is also very good.
Before using insulin pump treatment, 8 patients had hypoglycemia. But to start using insulin pumps, only one patient low blood sugar occurs. Have two starting insulin pump therapy because of mild ketoacidosis and hospitalization of pregnant women in the perinatal period and no significant side effects.
Gabbe and colleagues reported that three groups of patients on maternal and neonatal complications, and no significant difference. These complications include problems during childbirth, neonatal Apgar score, neonatal hypoglycemia, and fetal malformations.
Although the research team reported that the group in the newborn and mother care costs there is no statistically significant differences, but the pump in the treatment group and the standard treatment group or a difference of 5,000 dollars. The authors attributed this difference in hospitalization costs of pump therapy group increased. Increase in hospital charges is used to prevent complications, and plans for the pump in the treatment of early start, late out-patient for the treatment of pump installation.
Cost analysis did not include the cost of insulin pumps nearly 5000 U.S. dollars. Gabbe and colleagues that if the pump in the treatment group, 94.7% of patients require continuous treatment with 6 year payment plan, then the additional cost does not increase significantly the total cost of the patient.
The authors also pointed out that the average 12-month postpartum follow-up, continued to pump therapy because of its significantly better than standard insulin therapy continued glycosylation level of hemoglobin A long-term benefit. Continued pump therapy glycosylation level of hemoglobin A, the average 7.2%, and continuing standard insulin treatment in A, glycosylated hemoglobin level of 9.1% on average.
Gabbe and colleagues concluded that many patients need continuous insulin pump therapy. As the mother of pump therapy can prevent the occurrence of subsequent vascular disease, and because of pump therapy to these patients in the second pregnancy can still get better blood sugar control, thereby reducing the risk of fetal abnormalities, so the total cost of pump therapy and other The difference between the treatment will be reduced to a minimum.
Saturday, May 1, 2010
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