提供者对妊娠自动化胰岛素装置的看法及在临床实践中实施的考虑。

IF 3.7 Q2 ENDOCRINOLOGY & METABOLISM
Jane Hand, Carol J Levy
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引用次数: 0

摘要

众所周知,1型糖尿病(T1D)患者的妊娠与孕产妇和新生儿的不良结局有关。虽然糖尿病技术的进步,特别是混合闭环(HCL)和高级混合闭环(AHCL)系统,大大提高了对非妊娠T1D患者的管理,但妊娠患者仍然是一个需要进一步研究的高危人群。现有的试验在血糖控制的临床意义方面显示了不同的数据,但这些数据可能是针对闭环系统的。目前,在英国、欧洲和澳大利亚有一种AHCL系统被批准并可用于合并糖尿病的妊娠。然而,在美国还没有食品和药物管理局(FDA)批准的用于怀孕期间的闭环系统。在美国,现有的HCL/AHCL系统在妊娠期的使用是标签外的,通常需要辅助技术来瞄准妊娠期所需的较紧的血糖水平。对于每日多次注射(mdi)或传感器增强泵治疗(SAPT)的患者,研究表明,HCL/ ahcl可以减轻护理负担,并使一些人达到更低的血糖水平。这篇综述的目的是提供闭环系统在妊娠合并T1D的现有证据的概述,并讨论其影响和考虑系统的使用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Provider Perspective on Automated Insulin Devices in Pregnancy and Considerations for Implementation in Clinical Practice.

Pregnancy in people with type 1 diabetes mellitus (T1D) is well-known to be linked to adverse maternal and neonatal outcomes. Although advancements in diabetes technology, especially hybrid closed-loop (HCL) and advanced hybrid closed-loop (AHCL) systems, have greatly enhanced management for nonpregnant individuals with T1D, pregnant patients still represent a high-risk group that requires further research. Existing trials have shown mixed data in terms of clinically meaningful benefits in glycemic control, but these may be specific to the closed-loop system. Currently, there is one AHCL system approved and available for use in pregnancies complicated by diabetes in the United Kingdom, Europe, and Australia. However, there are no Food and Drug Administration (FDA)-approved closed-loop systems for use during pregnancy in the United States. Existing HCL/AHCL system use is off-label for pregnancy in the United States and often requires assistive techniques to target the tighter glucose levels needed during pregnancy. For patients struggling on multiple daily injections (MDIs) or sensor-augmented pump therapy (SAPT), studies have shown that HCL/AHCLs can reduce the burden of care and enable some people to achieve tighter glucose levels. This review aims to provide an overview of the existing evidence of closed-loop systems in pregnancies complicated by T1D and to discuss their implications and considerations with system use.

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来源期刊
Journal of Diabetes Science and Technology
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.
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