Use of commercially available automated insulin delivery systems in pregnant people with type 1 diabetes

IF 7.4 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice Pub Date : 2025-09-01 DOI:10.1016/j.diabres.2025.112454

Angela Q. Pham , Ildiko Lingvay , Nicole Ahmadi , Patricia C. Santiago-Munoz , Marconi Abreu

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Abstract

Aims

Automated insulin delivery (AID) systems are first-line therapy for type 1 diabetes, but commercially available AIDs in the United States are not approved for pregnancy. We aimed to compare glycemic control achieved during pregnancy by people with type 1 diabetes using AIDs versus standard of care therapy (multiple daily injections and sensor augmented pump therapy).

Methods

This was a retrospective cohort study of people with type 1 diabetes who used a continuous glucose monitor (CGM) during pregnancy. The primary outcome was time in range (TIR); time below range (TBR), time above range, and glucose standard deviation were secondary outcomes. Outcomes were compared using analysis of covariance.

Results

38 people were included: 21 treated with AIDs and 17 with standard of care. The mean antenatal TIR in the AID group was 68.5 ± 12.9 % compared to 55.7 ± 16.7 % (adjusted mean difference 7.9 %, 95 % CI: 0.8 to 15.0, p = 0.03). The AID group achieved a lower TBR (1.7 ± 1.3 % vs 3.0 ± 2.8 %, p = 0.03), and lower glucose standard deviation (37.2 ± 8.0 vs 45.5 ± 8.9, p = 0.02) than standard of care.

Conclusions

In this real-world study, off-label AID use during pregnancy improved TIR while decreasing TBR. While awaiting commercially available AIDs with pregnancy algorithms, standardized approaches to optimizing current systems are needed.

Abstract Image

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1型糖尿病孕妇使用市售自动胰岛素输送系统。

目的：自动胰岛素输送（AID）系统是1型糖尿病的一线治疗方法，但在美国，市售的AIDs尚未被批准用于妊娠。我们的目的是比较1型糖尿病患者使用艾滋病与标准护理治疗（每日多次注射和传感器增强泵治疗）在妊娠期间实现的血糖控制。方法：这是一项对妊娠期间使用连续血糖监测仪（CGM）的1型糖尿病患者的回顾性队列研究。主要终点为范围内时间（TIR）；低于范围时间（TBR）、高于范围时间和葡萄糖标准偏差是次要结局。采用协方差分析比较结果。结果：38人被纳入：21人接受艾滋病治疗，17人接受标准治疗。平均产前行动援助组是68.5 ±12.9  % 55.7相比 ±16.7  %(调整后的平均差7.9 %、95 % CI: 0.8 - 15.0, p = 0.03)。援助团体取得了较低的创业(1.7 ±1.3  % 3.0 vs ±2.8  %,p = 0.03),和更低的葡萄糖标准偏差(37.2 ±8.0 vs 45.5  ± 8.9,p = 0.02)比标准的护理。结论：在这项现实世界的研究中，妊娠期间使用说明书外的AID可改善TIR，同时降低TBR。在等待商业上可用的怀孕算法的同时，需要标准化的方法来优化当前的系统。

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

Diabetes research and clinical practice 医学-内分泌学与代谢

CiteScore

10.30

自引率

3.90%

发文量

862

审稿时长

32 days

期刊介绍： Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.