New and Updated Cochrane Systematic Reviews
Continuous subcutaneous insulin infusion versus multiple daily injections of insulin for pregnant women with diabetes
Authors' conclusions: There is no evidence to support the use of one particular form of insulin administration over another for pregnant women with diabetes. There are only a small number of trials appropriate for meta-analysis, a small number of women included and questionable generalisability of the trial population.
Pump technology has progressed since these trials were undertaken. Well-designed randomised trials are required to evaluate comparisons such as patch pumps against MDI and more conventional CSII against MDI. These trials should be adequately powered to assess the effect of interventions, and report the core set of outcomes used in Cochrane reviews of diabetes in pregnancy. Trials to assess the effects of pumps on birthweight and macrosomia rates are needed. It would be beneficial for future trials to undertake longer-term follow-up of participants and their infants, assess women's preferences, and conduct an economic evaluation.
Did you know that you now have free access to Cochrane Clinical Answers?
It provides brief evidence based summaries of information on popular clinical questions and links to the evidence from Cochrane Reviews on those questions. Here is a link to the Cochrane Clinical Answers on Diabetes, to give you an idea of what is available:
Cochrane Clinical Answers on Diabetes
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