Glycemic control and maternal and fetal outcomes in pregnant women with type 1 diabetes according to the type of basal insulin

Chico, Ana; Herranz, Lucrecia; Corcoy, Rosa; Ramírez, O.; Goya, María; Bellart, Jordi; González-Romero, Stella; Codina, Mercedes; Sánchez, Petra; Cortázar, Alicia; Acosta, Domingo; Picón-César, María José; Rubio, José António; Megía, Ana; Sancho, M.; Balsells, Montserrat; Solá, Eva; González, Nieves Luisa González; López-López, J.

doi:10.1016/j.ejogrb.2016.07.490

Cited by 19 publications

(16 citation statements)

References 24 publications

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“…Previous studies have shown that pre‐pregnancy planning improves gestational outcomes, including A1C . All three cases developed preeclampsia and LGA infants, both being common among women with T1D, with rates of 5%‐34% and 29%‐63%, respectively . This case series cannot assess the adequacy of HCL therapy to improve gestational outcomes, to do so would require a large randomized‐controlled trial.…”

Section: Discussionmentioning

confidence: 91%

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Case series of a hybrid closed‐loop system used in pregnancies in clinical practice

Polsky

Aktürk

2019

Diabetes Metabolism Res

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Background Hybrid closed‐loop (HCL) therapy is rarely studied in pregnancy. We present three cases of women with type 1 diabetes who used the Medtronic 670G HCL system for most or all of gestation. Methods The Medtronic 670G system has a manual mode (no automated insulin delivery) and an auto mode (AM, HCL therapy). Women in this case series used AM off‐label in gestation. Results Case 1 started HCL therapy in the second trimester, her sensor glucose time spent <3.9 and >10 mmol/L improved thereafter. Case 1 had average sensor glucose (ASG) levels of 6.4 ± 2.4 mmol/L in the first trimester, 7.0 ± 2.7 mmol/L in the second trimester before HCL use, 7.1 ± 2.1 mmol/L in the second trimester after HCL use, and 6.8 ± 1.9 mmol/L in the third trimester. Case 1 continued AM during operative delivery and post‐partum. Cases 2 and 3 used HCL therapy throughout gestation but with inconsistent time in AM. When they increased time in AM their glycaemic indices improved. Case 2 had ASG of 9.5 ± 3.4, 8.6 ± 2.9, and 7.9 ± 2.5 mmol/L in the first through third trimesters, respectively. Case 3 had ASG of 11.1 ± 4.8 and 3.9 to 10 mmol/L in the first and second trimesters, respectively. Case 2 continued HCL therapy post‐partum, Case 3 did not. Conclusions CareLink® Clinical Software only reports the non‐pregnant time in range. Nonetheless, this represents the first report of HCL therapy in pregnancy with a system approved by the Food and Drug Administration in non‐pregnant populations.

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Section: Discussionmentioning

confidence: 91%

“…[20][21][22] All three cases developed preeclampsia and LGA infants, both being common among women with T1D, with rates of 5%-34% and 29%-63%, respectively. [23][24][25][26][27][28][29][30] This case series cannot assess the adequacy of HCL therapy to improve gestational outcomes, to do so would require a large randomized-controlled trial.…”

Section: Discussionmentioning

confidence: 99%

Case series of a hybrid closed‐loop system used in pregnancies in clinical practice

Polsky

Aktürk

2019

Diabetes Metabolism Res

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“…Два быстродействующих аналога инсулина, лизпро и аспарт, в настоящее время разрешены к применению у беременных с СД-1 на основании результатов рандомизированных клинических испытаний (РКИ) [12]. В связи с тем, что в многочисленных исследованиях данные препараты показали исходы беременности для матери, плода и новорожденного, аналогичные исходам у пациенток, применяющих обычный человеческий инсулин, аналоги инсулина лизпро и аспарт признаны достаточно безопасными и эффективными, и классифицируются как категория риска для беременности B [13][14][15].…”

Section: прогресс в лечении сд-1 у беременных женщинunclassified

“…Глюлизин -еще один быстродействующий аналог инсулина, доступный для использования в общей диабетической популяции. Тем не менее, нет контролируемых исследований, посвященных его безопасности во время беременности [12], и глюлизин не рекомендуется беременным женщинам с СД-1.…”

Section: прогресс в лечении сд-1 у беременных женщинunclassified

Features of insulin therapy in patients with type 1 diabetes mellitus during pregnancy

Zhuravlyova¹,

Rogachova²

2018

Shidnoevr. z. vnutr. simejnoi med.

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Until recently, pregnancy in type 1 diabetes mellitus caused high risk of complications for the mother and severe congenital abnormalities for the child. The main problems of pregnant women with diabetes were difficulties in achieving stable normal blood glucose level, avoiding hypoglycemia and ketoacidosis. Control of DM-1 during pregnancy is significantly complicated by the addition of physiological insulin resistance. In connection with hormonal changes, the need for insulin and insulin sensitivity vary significantly during different periods of pregnancy. The degree of expression of these changes is individual. During the last 10 years, there has been significant progress in the level of knowledge about the patterns of the course of DM-1 in pregnancy, also in methods of blood glucose monitoring and insulin delivery. Synthetic insulin analogues were developed and introduced into practice. After carefully studying the latest scientific evidence based data, we reviewed the latest advances in the treatment of diabetes type 1 in pregnant women.

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“…. By contrast, women on MDI, who usually use NPH as a basal insulin , may be protected from fetal growth acceleration and hyperglycaemia in the middle of the night, due to the action peak 4 h after the injection of NPH . This possibility of nocturnal hyperglycaemia seems a good argument to perform continuous glucose monitoring during pregnancies complicated by diabetes, and it would be interesting to know whether the type of long‐acting insulin (NPH vs glargine) did influence the outcomes for the participants on MDI in the study by Hauffe et al .…”

mentioning

confidence: 99%

Why might pumps fail in pregnant women with Type 1 diabetes?

et al. 2019

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Glycemic control and maternal and fetal outcomes in pregnant women with type 1 diabetes according to the type of basal insulin

Abstract: In this observational study of pregnant women with T1DM, the type of basal insulin was independently associated with metabolic variables and foetal outcomes.

Cited by 19 publications

References 24 publications

Case series of a hybrid closed‐loop system used in pregnancies in clinical practice

Case series of a hybrid closed‐loop system used in pregnancies in clinical practice

Features of insulin therapy in patients with type 1 diabetes mellitus during pregnancy

Why might pumps fail in pregnant women with Type 1 diabetes?

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