Introduction: CSII (continuous subcutaneous insulin infusion) therapy is an accepted form of treatment for Type 1 diabetes and is used widely in Type 1 and pregnancy but not as often in Type 2.
Background: KW is a 35 year old obese woman who has had Type 2 diabetes for 8yrs, 6 of these on insulin. She has a past history of Polycystic Ovarian Syndrome. KW was managed on basal bolus insulin, totalling 178 units per day. KW had undertaken 6 IVF attempts, none of which were successful. HbA1c- pre CSII was 7.8% with regular hypos and extreme glycaemic variability.
Method: KW was referred to me by her Endocrinologist for assessment for suitability for a new Type 2 program with an insulin pump company. Her suitability was established and a plan for her admission to a private hospital to commence CSII was developed in collaboration with the patient, CDE and Endocrinologist.
Outcomes: The successful commencement of KW on CSII. Total daily insulin dose reduced by 50% and cessation of glycaemic variability. KW experienced a weight loss of 14 kg over 6 months with an HbA1c reduction to 5.9%. On the seventh round of IVF, KW became pregnant with baby due late July 2016. KW believes the pump has been life changing for her and was thrilled at finally having a successful pregnancy after years of trying. The pregnancy path was smooth with no extreme fluctuation in her BG levels? But complications occurred at 24 weeks not diabetes or CSII related. Mother and baby are progressing well at the time of writing this abstract.
Conclusion: CSII may have even greater beneficial effects for those with Type 2 diabetes and should be considered more in Type 2 and pregnancy.