August 24th, 2017

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Title:
Prenatal Use of V-Go Insulin Delivery System: A Case Report
Authors:  Shadi Rezai, M.D., Andres Molina, B.S., Hasan Nezam, M.D., Ray Mercado, D.O., and Cassandra Henderson, M.D.
 
BACKGROUND: Pregestational diabetes complicates approximately 1% of pregnancies. We describe the use of V-Go disposable insulin delivery device to manage a pregnancy complicated by type 1 diabetes (T1DM) with prolonged periods of unmet glycemic targets. Persistent glucose variability is a frequent complication of T1DM. Continuous subcutaneous insulin infusion via insulin pumps is an accepted therapeutic option to address this clinical problem.

CASE: A 24-year-old Hispanic primigravida with T1DM for 14 years, chronic hypertension, and chronic proteinuria presented at 8 weeks’ gestation with an A1C of 13.5%. The A1C remained elevated despite 4 weeks of insulin dose adjustments and adoption of medical nutrition therapy. The patient declined continuous subcutaneous insulin infusion via insulin pump but agreed at 12 weeks’ gestation to use V-Go as a device to continuously infuse subcutaneous insulin. After V-Go was used to replace multiple daily insulin injections, the percent of glycemic targets met increased from 5% to 80%, and A1C decreased to her lowest level in 8 years, 9.8%. Use of the disposable V-Go insulin infusion device facilitated our patient’s adherence to the prescribed insulin regimen, which ultimately led to more glycemic targets being met.

CONCLUSION: V-Go is a viable alternative to insulin pump therapy for continuous subcutaneous insulin infusion during pregnancy.
Keywords:  blood glucose self-monitoring; diabetes, pregnancy-induced; diabetes mellitus; gestational diabetes; glycated hemoglobins; insulin infusion systems; insulin pump; type 1 diabetes; type 2 diabetes
   
   
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