Automated insulin delivery in pregnant women complicated by Type 1 diabetes

A study supported by JDRF has found that hybrid closed-loop technology improves maternal glucose levels during pregnancy complicated by Type 1 diabetes, compared to traditional insulin pumps or multiple daily injections.

Hormonal changes during pregnancy mean that most women struggle to reach recommended blood sugar targets, which means that complications related to having Type 1 diabetes during pregnancy are widespread, affecting one in every two newborn babies. For the baby, these include premature birth, need for intensive care after birth, and being too large at birth, which increases the lifelong risk of overweight and obesity. Low blood sugars, excess weight gain, and high blood pressure during pregnancy are common amongst mothers.

The study, funded by a partnership between the National Institute for Health and Care Research (NIHR) and the Medical Research Council (MRC), involved 124 pregnant women with Type 1 diabetes aged 18-45 years who managed their condition with daily insulin therapy. Half were randomly allocated to use the Hybrid Closed-Loop technology, and half to use the traditional insulin therapy (insulin pumps or multiple daily injection methods). They took part for approximately 24 weeks (from 10-12 weeks) until the end of pregnancy.

On average, pregnant women used the Hybrid Closed-Loop technology for more 95% of the time. Compared to traditional insulin therapy methods, women who used the technology spent more time in the target range for pregnancy blood sugar levels (68% vs 56% – equivalent to an additional 2.5-3.0 hours every day throughout pregnancy).  Importantly, women using the technology also had fewer antenatal clinic appointments, and fewer out-of-hours calls with maternity clinic teams, suggesting that this technology could also be time saving for pregnant women and for stretched maternity services.

The study’s authors say that hybrid closed-loop technology should now be offered to all pregnant women with type 1 diabetes.

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