A Case of Type 1 Diabetic Pregnant Woman Managed With a Sensor Augmented Pump (SAP)

Abstract

A 23-year-old woman with a history of type 1 diabetes mellitus since 4 years of age achieved poor blood glucose control with continuous subcutaneous insulin infusion (CSII). In 2014, she elected to receive care in our department. She was subsequently found to be 7 weeks pregnant, and she was admitted to our hospital with a glycated hemoglobin (HbA1c) value of 10.0 %, indicating poor blood glucose control. We provided education to the patient and began treatment with a sensor augmented pump (SAP) for blood glucose control. When the patient was discharged, she was capable of self-management and had achieved improved blood glucose control, and we continued to follow up with outpatient visits. However, she was unable to comply with her diet therapy regimen, gaining substantial weight, and was readmitted for obstetric care at 34 weeks of gestation with a suspected large for gestational age fetus. The patient was again managed with diet therapy and SAP. She underwent a caesarean section at 38 weeks of gestational, delivering a girl weighing 3,850 g. The neonate was hypoglycemic but free of deformation. Switching to SAP in early pregnancy allowed satisfactory blood glucose control through delivery. This case is particularly informative due to the paucity of reports regarding the use of SAP to manage diabetes in pregnancy in Japan.