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Insulin Delivery and Glucose Monitoring Methods for Diabetes Mellitus: Comparative Effectiveness

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Insulin Delivery With MDI Versus CSII in Pregnant Women With Pre-existing Diabetes

Six studies reported on effects of MDI and CSII on HbA1c. All six studies reported an improvement in HbA1c in both the CSII and MDI arms during pregnancy from the first to the third trimesters but no statistically significant difference in HbA1c between groups in any of the trimesters. The strength of evidence for this finding was rated as low.

The strength of evidence for all other findings related to pregnant women with pre-existing diabetes (including maternal hypoglycemia, maternal weight gain, rate of cesarean sections, and neonatal outcomes) was rated as insufficient.

Abbreviations: 95% CI = 95-percent confidence interval; CSII = continuous subcutaneous insulin infusion; HbA1c = hemoglobin A1c; MDI = multiple daily injections