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Title: The efficacy and safety of continuous subcutaneous insulin infusion (CSII) versus multiple daily injections (MDI) in pregnant women with type 1 diabetes mellitus

Author:

Ryś, Przemysław

Date:

2016

Type:

Praca doktorska

Abstract:

The aim of this doctoral dissertation is the evaluation of efficacy and safety of continuous subcutaneous insulin infusion (CSII) versus multiple daily injections (MDI) in women with pre-gestational diabetes (PGDM) based on the systematic review of randomized and observational studies. Additionally, methodological issues were also considered including the impact of observational studies and conference abstracts on the results of systematic reviews.The systematic search retrieved 38 original papers, including 15 conference abstracts. The majority of studies were open label, nonrandomized controlled trials with high risk of selection bias. Overall, the studies reported on 4499 pregnancies complicated by T1DM, out of which 183 were included in RCTs.Meta-analyses of available studies has shown that the difference between CSII and MDI with respect to HbA1c was largest in the 1st trimester (WMD = -0.45% [-0.64; -0.26]) and became less pronounced over the course of pregnancy, reaching the value of WMD = -0.24% [-0.39; -0.10] and WMD = -0.11% [-0.22; -0.001] in the 2nd and the 3rd trimester, respectively. In CSII group weight gain during pregnancy was higher while daily insulin dose was lower in all 3 trimesters.No significant difference between CSII and MDI was noticed with respect to maternal complications as well as to the majority of fetal complications. The percentage of neonates with birth weight large for gestational age (>90th percentile) was significantly higher in the CSII group (RR = 1.20 [1.07; 1.35]).For the majority of outcomes meta-analyses solely based on full text papers were consistent with base case analysis.

Place of publishing:

Kraków

Level of degree:

2 - studia doktoranckie

Degree discipline:

endokrynologia ; położnictwo

Degree grantor:

Uniwersytet Jagielloński. Collegium Medicum. Katedra i Klinika Chorób Metabolicznych.

Promoter:

Maciej T. Małecki

Date issued:

2015

Format:

application/pdf

Identifier:

oai:dl.cm-uj.krakow.pl:4170

Call number:

ZB-126050

LinkKatalogExplorUJ:

click here to follow the link

Language:

pol

Access rights:

tylko w bibliotece

Location of original object:

Biblioteka Medyczna Uniwersytetu Jagiellońskiego- Collegium Medicum

Subject and keywords:

pre-gestational diabetes systematic review meta-analysis continuous subcutaneous insulin infusion

Object collections:

Last modified:

Jun 26, 2017

In our library since:

Jun 26, 2017

Number of object content hits:

9

Number of object content views in PDF format

6

All available object's versions:

http://dl.cm-uj.krakow.pl:8080/publication/4171

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ZB-126050 Jun 26, 2017

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