The Effects of Continuous Insulin Pump Therapy on Glycemic Control in Pregnant Type 1 Diabetics

Abstract

Type 1 Diabetics have various ways of managing their diabetes that have been studied for their effectiveness. Pregnancy in the Type 1 Diabetic has been understudied. It is known that Diabetics in general have poorer pregnancy outcomes because of poor glycemic control. This coupled with the fact that the body needs 3-4 times more insulin as pregnancy comes to an end makes managing blood glucose levels challenging for diabetics (Lowdermilk, 2016, p. 689). For the Type 1 Diabetic, there are two main ways to control diabetes: multiple daily injections using at least two type of insulin and continuous subcutaneous insulin injections, also known as an insulin pump, which uses one type of insulin. Research shows that insulin pump therapy increases the amount of control over blood glucose levels safely throughout all three terms of pregnancy. It also shows that insulin pump therapy is more effective than multiple daily injections at maintaining consistent blood glucose levels and lower Ha1C levels. Improvements need to be made at the labor and delivery level of care. Currently patients are put on an intravenous insulin drip once they enter into the hospital. Limited research has been preformed during this crucial time to see the safety and effectiveness of insulin pump therapy during this stage. One study showed that there was a higher percentage of success with regards to maintaining glucose levels in both mother and infant when an insulin pump was continued. These findings suggest that more research needs to be applied to the labor and delivery process of Type 1 Diabetics using insulin pumps to establish protocols for safety for both mother and baby. THE EFFECTS OF CONTINUOUS INSULIN PUMP THERAPY ON GLYCEMIC CONTROL IN PREGNANT TYPE 1 DIABETICS 4 Acknowledgements I would like to thank my mom for always encouraging me to have as normal a life style as possible. Even though I was diagnosed with Type 1 Diabetes Mellitus at 2 years of age, she never wanted this disease to stop me. Because of her constant support, I have achieved so much. She is always in the background when I need her and I could not have gotten where I am today without her. Dr. Luanne Linnard-Palmer, no matter what situation, always provides encouragement and motivation. I want to thank her for being willing to sit with me when I wanted to know I was on the right tract. Also, I would like to thank my partner Josh. Throughout our relationship including my time in nursing school he has been a constant support for me. Together we strive for excellence and encourage each other to do great things. He has learned my form of this disease and can often predict my blood sugar levels going low or high before I can. With his help, and the research put in for this thesis, I know he and I will have successful pregnancies in spite of the fact that I am a Type 1 Diabetic. His encouragement has meant so much to me and has helped me to complete what I find to be important work.