Comparative Effectiveness of Continuous Subcutaneous Insulin Infusion Using Insulin Analogs and Multiple Daily Injections in Pregnant XXXX with @entity6 : A Systematic Review and Meta-Analysis.

@entity1 @entity164 @entity2794 @entity6
UNASSIGNED: We systematically reviewed the effectiveness and safety of continuous subcutaneous insulin infusion (CSII) with insulin analogs compared with @entity2794 ( @entity2794 ) in pregnant @entity1 with @entity6 . We searched Medline  , Embase  , and the Cochrane Central Register of Controlled Trials through May 2013. Studies comparing CSII with @entity2794 in pregnant @entity1 with @entity6 were included. Studies using regular insulin CSII were excluded. We conducted meta-analyses where there were two or more comparable studies based on the @entity164 of insulin used in the @entity2794 arm. Seven cohort studies of pregnant @entity1 with @entity164 1 @entity6 reported improvement in hemoglobin A1c (HbA1c) in both groups. Meta-analysis showed no difference in maternal and fetal outcomes for CSII versus @entity2794 . Results were similar when CSII was compared with @entity2794 with insulin analogs or regular insulin. Studies had moderate to high risk bias with incomplete descriptions of study methodology, populations, treatments, follow up, and outcomes. We conclude that observational studies reported similar improvements in HbA1c with CSII and @entity2794 during pregnancy, but evidence was insufficient to rule out possible important differences between CSII and @entity2794 for maternal and fetal outcomes. This highlights the need for future studies to examine the effectiveness and safety of CSII with insulin analogs and @entity2794 in pregnant @entity1 with @entity6 .
