Summary of findings for the main comparison. CSII versus MDI: maternal outcomes.
| Continuous subcutaneous insulin infusion (CSII) versus multiple daily injections (MDI) of insulin for pregnant women with diabetes | ||||||
| Patient or population: pregnant women with diabetes Setting: 3 studies in Italy Intervention: CSII Comparison: MDI | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Risk with MDI | Risk with GRADE CSII | |||||
| Hypertensive disorders of pregnancy (including pre‐eclampsia, pregnancy‐induced hypertension, eclampsia) | (0 studies) | outcome not reported | ||||
| Caesarean section | Study population | RR 1.09 (0.66 to 1.77) | 71 (3 RCTs) | ⊕⊝⊝⊝ VERY LOW 1 2 | ||
| 444 per 1000 | 484 per 1000 (293 to 787) | |||||
| Moderate | ||||||
| 438 per 1000 | 477 per 1000 (289 to 774) | |||||
| Development of Type 2 diabetes | (0 studies) | outcome not reported | ||||
| Perineal trauma | (0 studies) | outcome not reported | ||||
| Return to pre‐pregnancy weight | (0 studies) | outcome not reported | ||||
| Postnatal depression | (0 studies) | outcome not reported | ||||
| Induction of labour | (0 studies) | outcome not reported | ||||
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio | ||||||
| GRADE Working Group grades of evidence High quality: We are very confident that the true effect lies close to that of the estimate of the effect Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect | ||||||
1 All studies contributing data had design limitations.
2 Wide confidence interval crossing the line of no effect, and small sample size.