부산대학교 도서관

A 48-year-old Japanese woman had been diagnosed with type 2 diabetes mellitus at 22 years old and started receiving treatment with oral antidiabetic drugs at 23 years old. The patient had received multiple daily injection insulin therapy at 24 years old during her first pregnancy. She conceived naturally at 48 years old; however, the control of her diabetes was poor (HbA1c 9.3 %) despite the use of insulin aspart (21 units/day) and insulin glargine (24 units/day). She was therefore admitted to Mie University Hospital, where she received sensor-augmented pump (SAP) therapy and frequent nutrition guidance from eight weeks' gestation. After starting SAP therapy, the patient's HbA1c levels ranged from 6.2 %-7.2 %, and the parameters of glucose variability (mean amplitude of glycemic excursions, standard deviation, and M-value) improved. She underwent Caesarean section at 37 weeks' gestation, delivering a boy at 2,985 g. This is the first case of an older, high-risk pregnant patient with type 2 diabetes mellitus receiving SAP therapy.