Technology advances in diabetes pregnancy: right technology, right person, right time.

IF 8.4 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Diabetologia Pub Date : 2024-10-01 Epub Date: 2024-07-05 DOI:10.1007/s00125-024-06216-2
Anna McLean, Louise Maple-Brown, Helen R Murphy
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Abstract

This review outlines some of the extraordinary recent advances in diabetes technology, which are transforming the management of type 1 diabetes before, during and after pregnancy. It highlights recent improvements associated with use of continuous glucose monitoring (CGM) but acknowledges that neither CGM nor insulin pump therapy are adequate for achieving the pregnancy glucose targets. Furthermore, even hybrid closed-loop (HCL) systems that are clinically effective outside of pregnancy may not confer additional benefits throughout pregnancy. To date, there is only one HCL system, the CamAPS FX, with a strong evidence base for use during pregnancy, suggesting that the pregnancy benefits are HCL system specific. This is in stark contrast to HCL system use outside of pregnancy, where benefits are HCL category specific. The CamAPS FX HCL system has a rapidly adaptive algorithm and lower glucose targets with benefits across all maternal glucose categories, meaning that it is applicable for all women with type 1 diabetes, before and during pregnancy. For women of reproductive years living with type 2 diabetes, the relative merits of using non-insulin pharmacotherapies vs diabetes technology (dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter 2 inhibitors) are unknown. Despite the urgent unmet need and potential benefits, studies of pharmacotherapy and technology use are extremely limited in pregnant women with type 2 diabetes.

Abstract Image

孕期糖尿病的技术进步:正确的技术、正确的人、正确的时间。
本综述概述了糖尿病技术最近取得的一些非凡进展,这些进展正在改变孕前、孕期和产后的 1 型糖尿病管理。它重点介绍了与使用连续血糖监测(CGM)相关的最新进展,但也承认无论是 CGM 还是胰岛素泵疗法都不足以实现孕期血糖目标。此外,即使是在妊娠期外临床上有效的混合闭环(HCL)系统,也不一定能在整个妊娠期带来额外的益处。迄今为止,只有 CamAPS FX 一种混合闭环系统在孕期使用时具有坚实的证据基础,这表明孕期获益是混合闭环系统特有的。这与孕期外使用 HCL 系统形成鲜明对比,孕期外使用 HCL 系统的益处是 HCL 类别所特有的。CamAPS FX HCL 系统具有快速自适应算法和较低的血糖目标值,对所有孕产妇血糖类别都有益处,这意味着它适用于所有 1 型糖尿病妇女在怀孕前和怀孕期间。对于患有 2 型糖尿病的育龄妇女,使用非胰岛素药物疗法与糖尿病技术(二肽基肽酶-4 抑制剂、胰高血糖素样肽-1 受体激动剂和钠-葡萄糖共转运体 2 抑制剂)的相对优势尚不清楚。尽管存在尚未满足的迫切需求和潜在益处,但针对 2 型糖尿病孕妇的药物疗法和技术使用研究却极为有限。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Diabetologia
Diabetologia 医学-内分泌学与代谢
CiteScore
18.10
自引率
2.40%
发文量
193
审稿时长
1 months
期刊介绍: Diabetologia, the authoritative journal dedicated to diabetes research, holds high visibility through society membership, libraries, and social media. As the official journal of the European Association for the Study of Diabetes, it is ranked in the top quartile of the 2019 JCR Impact Factors in the Endocrinology & Metabolism category. The journal boasts dedicated and expert editorial teams committed to supporting authors throughout the peer review process.
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