Automated insulin delivery in pregnant women with type 1 diabetes mellitus: a systematic review and meta-analysis.

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Acta Diabetologica Pub Date : 2025-01-10 DOI:10.1007/s00592-025-02446-x

Athina Stamati, Athanasios Christoforidis

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Abstract

Aims: To assess the efficacy and safety of automated insulin delivery (AID) systems compared to standard care in managing glycaemic control during pregnancy in women with Type 1 Diabetes Mellitus (T1DM).

Methods: We searched MEDLINE, Cochrane Library, registries and conference abstracts up to June 2024 for randomized controlled trials (RCTs) and observational studies comparing AID to standard care in pregnant women with T1DM. We conducted random effects meta-analyses for % of 24-h time in range of 63-140 mg/dL (TIR), time in hyperglycaemia (> 140 mg/dl and > 180 mg/dL), hypoglycaemia (< 63 mg/dl and < 54 mg/dL), total insulin dose (units/kg/day), glycemic variability (%), changes in HbA1c (%), maternal and fetal outcomes.

Results: Thirteen studies (450 participants) were included. AID significantly increased TIR (Mean difference, MD 7.01%, 95% CI 3.72-10.30) and reduced time in hyperglycaemia > 140 mg/dL and > 180 mg/dL (MD - 5.09%, 95% CI - 9.41 to - 0.78 and MD - 2.44%, 95% CI - 4.69 to - 0.20, respectively). Additionally, glycaemic variability was significantly reduced (MD - 1.66%, 95% CI - 2.73 to - 0.58). Other outcomes did not differ significantly.

Conclusion: AID systems effectively improve glycaemic control during pregnancy in women with T1DM by increasing TIR and reducing hyperglycaemia without any observed adverse short-term effects on maternal and fetal outcomes.

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1型糖尿病孕妇自动胰岛素输送：一项系统综述和荟萃分析

目的：评估自动胰岛素输送（AID）系统在1型糖尿病（T1DM）妇女妊娠期血糖控制管理中的有效性和安全性。方法：我们检索MEDLINE、Cochrane图书馆、截止到2024年6月的注册库和会议摘要，以比较AID与标准治疗对妊娠T1DM患者的影响的随机对照试验（rct）和观察性研究。我们对24小时内63-140 mg/dL （TIR）、高血糖（>40 mg/dL和> 180 mg/dL）、低血糖的百分比进行了随机效应荟萃分析(结果：纳入13项研究（450名参与者）。AID显著提高了TIR（平均差值，MD为7.01%，95% CI为3.72-10.30），并缩短了高血糖期（MD为- 5.09%，95% CI为- 9.41 - - 0.78，MD为- 2.44%，95% CI为- 4.69 - - 0.20）。此外，血糖变异性显著降低（MD - 1.66%, 95% CI - 2.73至- 0.58）。其他结果没有显著差异。结论：AID系统通过增加TIR和降低高血糖，有效改善T1DM妇女妊娠期间的血糖控制，未观察到对母胎结局的短期不良影响。

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

Acta Diabetologica 医学-内分泌学与代谢

CiteScore

7.30

自引率

2.60%

发文量

180

审稿时长

2 months

期刊介绍： Acta Diabetologica is a journal that publishes reports of experimental and clinical research on diabetes mellitus and related metabolic diseases. Original contributions on biochemical, physiological, pathophysiological and clinical aspects of research on diabetes and metabolic diseases are welcome. Reports are published in the form of original articles, short communications and letters to the editor. Invited reviews and editorials are also published. A Methodology forum, which publishes contributions on methodological aspects of diabetes in vivo and in vitro, is also available. The Editor-in-chief will be pleased to consider articles describing new techniques (e.g., new transplantation methods, metabolic models), of innovative importance in the field of diabetes/metabolism. Finally, workshop reports are also welcome in Acta Diabetologica.