Comparison of Insulin Pump and MDI for Pregestational Diabetes During Pregnancy

Inclusion Criteria: * subjects are attending the Diabetes Pregnancy Clinic at participating hospitals * have had type 1 or type 2 diabetes for at least one year * are in the first trimester or are actively attempting pregnancy * have a singleton pregnancy * are receiving intensive insulin therapy * are judged by clinic staff to be capable of using an insulin pump * are age 19 or older * are willing to adhere to the study protocol including monitoring blood glucose levels * are willing to take folic acid before pregnancy and during the first trimester * are willing to discontinue any medication contraindicated in pregnancy prior to conception * weigh less than 100 kg (220 lb) prior to becoming pregnant * use less than 100 units of insulin per day Exclusion Criteria: * current or previous use of an insulin pump * use of fertility treatments * have a multiple pregnancy * have had children born with major birth defects * have experienced stillbirth or multiple early pregnancy losses * have significant diabetes complications or a serious medical issue