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

Autor:

Ryś, Przemysław

Data:

2016

Typ:

Praca doktorska

Abstrakt:

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.

Miejsce wydania:

Kraków

Stopień studiów:

2 - studia doktoranckie

Dyscyplina:

endokrynologia ; położnictwo

Instytucja nadająca tytuł:

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

Promotor:

Maciej T. Małecki

Data wydania:

2015

Format:

application/pdf

Identyfikator:

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

Sygnatura:

ZB-126050

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Język:

pol

Prawa dostępu:

tylko w bibliotece

Lokalizacja oryginału:

Biblioteka Medyczna Uniwersytetu Jagiellońskiego- Collegium Medicum

Temat i słowa kluczowe:

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

Kolekcje, do których przypisany jest obiekt:

Data ostatniej modyfikacji:

26 cze 2017

Data dodania obiektu:

26 cze 2017

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

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Nazwa wydania Data
ZB-126050 26 cze 2017

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Biblioteka Medyczna
ul. Medyczna 7
30-688 Kraków

Telefon

12 658 72 56
517 385 669

E-Mail

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cyfrowabm@cm-uj.krakow.pl

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