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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Insulin pens have allowed flexibility in the lifestyle of patients with diabetes,¹ and their use has become widespread.² Pen use does not necessarily imply improvement in metabolic control, which may even deteriorate,^{1, 3} and technical problems can occur.^{2, 4-5} We describe 3 pregnant women with diabetes in whom metabolic control deteriorated owing to pen malfunction.

Report of Cases.

Case 1.

A 23-year-old pregnant woman with type 1 diabetes mellitus treated with preprandial regular insulin plus isophane insulin at bedtime phoned the hospital in her eighth week of pregnancy because of deterioration in the control of her blood glucose (BG) levels in the preceding 24 hours. Usual causes were ruled out. Over the next 2 days, her fasting BG levels ranged from 5.8 to 10.5 mmol/L (105-189 mg/dL), 11.1 to 21.1 mmol/L (200-380 mg/dL) during the day, and 22.2 to 26.2 mmol/L (400-473 mg/dL) at bedtime even though the dosage of her insulin was increased as much as . . . [Full Text of this Article]

Case 2.

Case 3.

Comment.

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