Practical Approach to Continuous Glucose Monitoring (CGM) Interpretation and Automated Insulin Delivery (AID) Use in Pregnancy: Considerations for Obstetric Providers.

IF 3.7 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Science and Technology Pub Date : 2025-05-13 DOI:10.1177/19322968251330651

Emily D Szmuilowicz, Celeste Durnwald, Denice S Feig

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引用次数: 0

Abstract

While automated insulin delivery (AID) systems have multiple well-established benefits outside of pregnancy and are widely used in non-pregnant individuals with type 1 diabetes (T1D), none of the commercially available AID systems in North America are approved for use during pregnancy. Use of commercially available AID systems off-label in pregnancy is currently limited by: (1) glucose targets higher than the fasting glucose target range recommended during pregnancy and (2) algorithms which were not designed for the dynamic changes in insulin resistance which occur across gestation. However, as AID use in the general population expands, many individuals will opt to continue using these systems off-label during pregnancy, and thus, guidance for providers regarding AID use and optimization during pregnancy is of the utmost importance. A cornerstone to the effective use of AID systems is the systematic and accurate interpretation of continuous glucose monitoring (CGM) data. One obstacle to the use of both CGM and AID systems by obstetric providers is the lack of comfort with CGM interpretation. We therefore present here: (1) a systematic approach to CGM interpretation during pregnancy and (2) practical guidance regarding AID use during pregnancy for individuals who opt to use commercially available AID systems off-label during pregnancy after consideration of individualized risks and benefits.

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妊娠期持续血糖监测（CGM）解释和自动胰岛素输送（AID）使用的实用方法：产科提供者的考虑。

虽然自动化胰岛素输送（AID）系统在妊娠期外具有多种公认的益处，并广泛用于非妊娠1型糖尿病（T1D）患者，但北美尚未批准商业化的AID系统用于妊娠期。目前，在妊娠期间使用市售AID系统的限制是：(1)血糖指标高于妊娠期间推荐的空腹血糖目标范围；(2)算法不是针对妊娠期间胰岛素抵抗的动态变化而设计的。然而，随着艾滋病在普通人群中的使用扩大，许多人将选择在怀孕期间继续使用这些系统，因此，为提供者提供关于怀孕期间艾滋病使用和优化的指导是至关重要的。有效使用AID系统的基石是对连续血糖监测（CGM）数据的系统和准确解释。产科提供者使用CGM和AID系统的一个障碍是对CGM的解释缺乏舒适性。因此，我们在此提出：(1)一个系统的方法来解释妊娠期间的CGM；(2)在考虑个体化风险和收益后，为那些在妊娠期间选择使用标签外的市售AID系统的个体提供妊娠期间使用AID的实用指导。

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

Journal of Diabetes Science and Technology Medicine-Internal Medicine

CiteScore

7.50

自引率

12.00%

发文量

148

期刊介绍： The Journal of Diabetes Science and Technology (JDST) is a bi-monthly, peer-reviewed scientific journal published by the Diabetes Technology Society. JDST covers scientific and clinical aspects of diabetes technology including glucose monitoring, insulin and metabolic peptide delivery, the artificial pancreas, digital health, precision medicine, social media, cybersecurity, software for modeling, physiologic monitoring, technology for managing obesity, and diagnostic tests of glycation. The journal also covers the development and use of mobile applications and wireless communication, as well as bioengineered tools such as MEMS, new biomaterials, and nanotechnology to develop new sensors. Articles in JDST cover both basic research and clinical applications of technologies being developed to help people with diabetes.