Closed-Loop Insulin Delivery Promising in T1DM Pregnancy
FRIDAY, March 16, 2018 -- For pregnant women with type 1 diabetes, a closed-loop system is associated with comparable glucose control and significantly less hypoglycemia than sensor-augmented pump (SAP) therapy, according to a study published online March 13 in Diabetes Care.
Zoe A. Stewart, from the University of Cambridge in the United Kingdom, and colleagues recruited 16 pregnant women to an open-label randomized trial. Participants completed 28 days of closed-loop and SAP insulin delivery separated by a washout period; for up to six weeks postpartum, participants could continue to use the closed-loop system.
The researchers found that the proportion of time with glucose levels within target was comparable for the closed-loop and SAP insulin delivery periods (62.3 versus 60.1 percent). There was also no difference in the mean glucose (131.4 versus 131.4 mg/dL) and time spent hyperglycemic >140 mg/dL (36.6 versus 36.1 percent). Significantly fewer hypoglycemic episodes (median, 8.0 versus 12.5), and less time at <63 mg/dL (1.6 versus 2.7 percent) occurred during closed-loop; the rates of hypoglycemia <50 mg/dL (0.24 versus 0.47 percent) and low blood glucose index (1.0 versus 1.4) were significantly lower. During closed-loop therapy there was significantly less nocturnal hypoglycemia (1.1 versus 2.7 percent).
"Larger, longer duration multicenter trials are now indicated to determine clinical efficacy of closed-loop insulin delivery in T1D pregnancy and the impact on neonatal outcomes," the authors write.
Several authors disclosed financial ties to the pharmaceutical and medical device industries; several authors reported related patents and patent applications.
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Posted: March 2018