Open-source automated insulin delivery systems for the management of type 1 diabetes during pregnancy

Bukhari, Khulood; Malek, Rana

doi:10.1136/bcr-2021-243522

Cited by 5 publications

(4 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Pregnancy use of DIY AID is reported in 10 individuals with; Loop (n = 7), AndroidAPS (n = 2) and OpenAPS (n = 1) [ 24 , 27 , 29 – 31 ]. TIR according to pregnancy targets (3.5–7.8mmol or 63-140mg/dL) was > 70% in every trimester in seven of these nine individuals.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

A scoping review of Do-It-Yourself Automated Insulin Delivery system (DIY AID) use in people with type 1 diabetes

et al. 2022

View full text Add to dashboard Cite

Introduction User designed Automated Insulin Delivery systems (AID), termed Do-It-Yourself (DIY) AID include; AndroidAPS, OpenAPS and Loop. These unregulated systems provide challenges for healthcare providers worldwide, with potential legal and ethical barriers to supporting their use. We performed a scoping review of the currently available literature surrounding DIY AID systems, specifically to highlight the evidence available to facilitate healthcare providers to support persons with diabetes who may benefit from DIY AID. Methods Studies relating to DIY AID systems were searched in Embase, Medline, Web of Science, Scopus, Proquest and Cochrane library until 31st December 2021. Publications were screened through title and abstract to identify study type and AID system type described. A thematic synthesis methodology was used for analysis of studies of DIY AID use due to the heterogeneity in study designs (case reports, qualitative, cross-sectional and cohort studies), with similarity in outcome themes. Results Following implementation of the search strategy, 38 relevant full texts were identified; comprising 12 case reports, 9 qualitative studies and 17 cohort studies, and data was also available from 24 relevant conference abstracts. No randomized studies were identified. Common themes were identified in the outcomes across the studies; glycemic variability, safety, quality of life, healthcare provider attitudes and social media. Conclusion There is extensive real-world data, but a lack of randomized control trial evidence supporting DIY AID system use, due to the user-driven, unregulated nature of these systems. Healthcare providers report a lack of understanding surrounding, and confidence in supporting, DIY AID despite impressive observational and user self-reported improvements in glycemic variability, without any reported safety compromises.

show abstract

Section: Resultsmentioning

confidence: 99%

“…The main characteristics of the case report studies are shown in Table 1 [20][21][22][23][24][25][26][27][28][29][30][31].…”

Section: Diy Aid Case Reportsmentioning

confidence: 99%

A scoping review of Do-It-Yourself Automated Insulin Delivery system (DIY AID) use in people with type 1 diabetes

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Until now, most studies on APS use in pregnant women with T1DM have been case reports, [12][13][14][15][16][17][18][19][20][21][22][23][24] with only a few available randomized controlled trials (RCTs) [25][26][27][28] and non-RCTs that have small sample sizes. 29,30 We conducted the present meta-analysis of the few RCTs to assess the efficacy of APS use among pregnant women with T1DM.…”

Section: Introductionmentioning

confidence: 99%

Effect of artificial pancreas system use on glycaemic control among pregnant women with type 1 diabetes mellitus: A meta‐analysis of randomized controlled trials

Lei,

Chen,

Ling

et al. 2023

Diabetes Obesity Metabolism

View full text Add to dashboard Cite

AimTo assess the efficacy of artificial pancreas systems (APS) use among pregnant women with type 1 diabetes mellitus (T1DM) by conducting a meta‐analysis.MethodsWe searched five databases, including EMBASE, Web of Science, PubMed, Cochrane Library and SCOPUS, for literature on APS use among pregnant women with T1DM before October 9, 2023. The primary endpoint was 24‐hour time in range (TIR; 3.5‐7.8 mmol/L). Secondary endpoints included glycaemic metrics for 24‐hour (mean blood glucose [MBG], time above range [TAR], time below range [TBR]), and overnight TIR and TBR.ResultsWe identified four randomized controlled trials involving 164 participants; one study with 16 participants focused on overnight APS use, and the other three focused on 24‐hour APS use. Compared with standard care, APS exhibited a favourable effect on 24‐hour TIR (standard mean difference [SMD] = 0.53, 95% confidence interval [CI] 0.25, 0.80, P < 0.001), overnight TIR (SMD = 0.67, 95% CI 0.39, 0.95, P < 0.001), and overnight TBR (<3.5 mmol/L; SMD = −0.49, 95% CI −0.77, −0.21 P < 0.001), while there was no significant difference in 24‐hour TAR, 24‐hour TBR, or MBG between the two groups. We further conducted subgroup analyses after removing the trial focused on overnight APS use and showed that 24‐hour APS use reduced not only the 24‐hour TIR (SMD = 0.41, 95% CI 0.12, 0.71; P = 0.007) but also the 24‐hour TBR (<2.8 mmol/L; SMD = −0.77, 95% CI −1.32, −0.23, P = 0.006).ConclusionOur findings suggest that APS might improve 24‐hour TIR and overnight glycaemic control, and 24‐hour APS use also significantly reduced 24‐hour TBR (2.8 mmol/L) among pregnant women with T1DM.

show abstract

“…The ongoing and rapid pace of development of diabetes technologies resulting in new technology such as automated insulin delivery (AID) systems, which many providers may be unfamiliar with, further exacerbates these situations where providers may be prone to remove technology that they are less experienced and familiar with. However, early research into both open source and commercial AID shows successful use of AID and diabetes self-management with technology in scenarios such as pregnancy and delivery, [5][6][7][8] surgery, 9,10 and other outpatient procedures.…”

mentioning

confidence: 99%

The Need for Diabetes Advance Directives to Support the Care of People With Diabetes

Lewis¹

2022

J Diabetes Sci Technol

View full text Add to dashboard Cite

It is time to adopt an advance directive specific to diabetes management. Research shows that people with diabetes in the hospital are often removed from existing diabetes self-management, resulting in poorer outcomes. Diabetes advance directives, which outline preferred diabetes self-management in scenarios such as hospitalization or outpatient procedures, are key for enabling patients with diabetes to continue successful diabetes management including use of existing diabetes technology. A diabetes advance directive is a new concept for both patients and providers that can improve clinical outcomes and patient-reported outcomes. Given the risk of harm in the absence of such a document, diabetes advance directives can be a useful new tool for patients and providers and to aid in the discussion, care planning, and self-management with diabetes technology.

show abstract

Open-source automated insulin delivery systems for the management of type 1 diabetes during pregnancy

Cited by 5 publications

References 12 publications

A scoping review of Do-It-Yourself Automated Insulin Delivery system (DIY AID) use in people with type 1 diabetes

A scoping review of Do-It-Yourself Automated Insulin Delivery system (DIY AID) use in people with type 1 diabetes

Effect of artificial pancreas system use on glycaemic control among pregnant women with type 1 diabetes mellitus: A meta‐analysis of randomized controlled trials

The Need for Diabetes Advance Directives to Support the Care of People With Diabetes

Contact Info

Product

Resources

About