Continuous Subcutaneous Insulin Infusion (CSII) versus Multiple Daily Injections (MDI): Impact on Glycemic Control and Pregnancy Outcomes in Gestational Diabetes

Objective: This study aims to compare the efficacy of two insulin administration methods — continuous subcutaneous insulin infusion (CSII) and multiple daily injections (MDI) — in managing glycemic levels and influencing pregnancy outcomes in gestational diabetes mellitus (GDM) patients. Methods: In total, 118 GDM patients admitted between January 2021 and May 2023 were randomly allocated into two groups using a computer-generated sequence. Patients in the MDI group received multiple daily injections, while those in the CSII group received continuous subcutaneous insulin infusion via an insulin pump. The study duration lasted from diagnosis until delivery. Glycemic control was measured by monitoring fasting blood glucose (FBG), postprandial blood glucose (PBG), and bedtime blood glucose (BBG) levels. Pregnancy outcomes included the incidence of hypoglycemia, premature rupture of membranes, postpartum hemorrhage, fetal distress, macrosomia, neonatal asphyxia, and preterm delivery. Results: Post-treatment, the CSII group showed better control of FBG, PBG, and BBG, which were significantly lower compared to the MDI group (p < 0.05). Furthermore, the incidence rates of complications such as hypoglycemia, fetal distress, neonatal asphyxia were significantly lower in the CSII group compared to the MDI group (p < 0.05). Conclusion: CSII offers better treatment outcomes for GDM patients compared to MDI. It effectively regulates blood glucose levels, optimizes pregnancy outcomes, and minimizes the risk of neonatal complications. Hence, CSII deserves further clinical endorsement and application. Clinical Trial Registration: The study has been registered on Chinese Clinical Trial Registration https://www.chictr.org.cn/ (registration number: ChiCTR2400088927).