Real‐world use of Control‐<scp>IQ</scp>™ technology automated insulin delivery in pregnancy: A case series with qualitative interviews

Wang, Xinye Serena; Dunlop, Amy D.; McKeen, Julie; Feig, Denice S.; Donovan, Lois

doi:10.1111/dme.15086

Cited by 15 publications

(3 citation statements)

References 28 publications

(54 reference statements)

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“…To our knowledge, there are four small observational real-life retrospective single-center studies [ 15 , 16 , 18 , 19 ] and one observational multicenter retrospective study [ 17 ] which examined the impact on glycemic profile, maternal and neonatal complications in pregnant women with T1DM using commercially available automated insulin delivery (AID) systems. An observational multicenter retrospective analysis [ 17 ] of thirteen pregnant women using the MiniMed TM 780G system including a twin pregnancy, showed improvement in glycemic control and met the recommended glucose targets only during nighttime (TIR > 70%).…”

Section: Discussionmentioning

confidence: 99%

“…To the best of our knowledge, no case report exists in the literature that uses the MiniMed TM 780G system in women with T1DM during gestation. Moreover, five small observational retrospective studies [ 15 , 16 , 17 , 18 , 19 ] examined the impact of a HCL system on the glycemic control of pregnant women with T1DM and maternal-neonatal complications. Four studies evaluate the use of the MiniMedTM 780G [ 15 , 16 , 17 , 18 ] system and one the use of Control-IQ system [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

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Use of Advanced Hybrid Closed-Loop System during Pregnancy: Strengths and Limitations of Achieving a Tight Glycemic Control

Giannoulaki,

Kotzakioulafi,

Nakas

et al. 2024

JCM

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Background: Pregnant women with type 1 diabetes mellitus (T1DM) face an elevated risk of complications for both themselves and their newborns. Experts recommend strict glycemic control. The advanced hybrid closed-loop (AHCL) system, though not officially approved for pregnant T1DM patients, is promising for optimal glycemic control. Methods: We collected CGM metrics, HbA1c levels, insulin pump settings, and doses from a 33-year-old pregnant woman with 23-year history of T1DM from the 6th week of gestation to birth. She was initially on continuous insulin pump therapy with CGM and switched to the AHCL system (MiniMedTM 780G, Medtronic, Northridge, CA, USA) between weeks 13 and 14. Results: The AHCL system improved glycemic control from weeks 14 to 26, achieving international guidelines with TIR = 72%, TAR = 24%, TBR = 4%. At week 30, TIR was 66%, TAR 31%. By altering diet and adding ‘fake carbohydrates’, she maintained TIR ≥ 70%, TBR ≤ 4%, TAR ≤ 26% from week 34 to birth. A healthy 4 kg, 53 cm baby boy was born at week 38. Conclusions: The use of the AHCL system holds significant promise for improving glycemic control in pregnancy. Optimal glycemic control with MiniMedTM 780G in pregnancy requires accurate carbohydrate counting, specific timing of insulin doses in relation to meal consumption and dietary choices that reduce the glycemic load of meals continue to be crucial factors in achieving optimal glycemic control during pregnancy using the MiniMedTM 780G system. Further research and clinical studies are needed to explore the full potential of these advanced systems in managing T1DM during pregnancy and optimizing maternal and neonatal outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Use of Advanced Hybrid Closed-Loop System during Pregnancy: Strengths and Limitations of Achieving a Tight Glycemic Control

Giannoulaki,

Kotzakioulafi,

Nakas

et al. 2024

JCM

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“…Until now, most studies on APS use in pregnant women with T1DM have been case reports, 12–24 with only a few available randomized controlled trials (RCTs) 25–28 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

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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.

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Efficacy and Safety of Different Hybrid Closed Loop Systems for Automated Insulin Delivery in People With Type 1 Diabetes: A Systematic Review and Network Meta‐Analysis

Di Molfetta,

Di Gioia,

Caruso

et al. 2024

Diabetes Metabolism Res

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AimsTo compare the efficacy and safety of different hybrid closed loop (HCL) systems in people with diabetes through a network meta‐analysis.MethodsWe searched MEDLINE, EMBASE, CENTRAL and PubMed for randomised clinical trials (RCTs) enrolling children, adolescents and/or adults with type 1 or type 2 diabetes, evaluating Minimed 670G, Minimed 780G, Control‐IQ, CamAPS Fx, DBLG‐1, DBLHU, and Omnipod 5 HCL systems against other types of insulin therapy, and reporting time in target range (TIR) as outcome.ResultsA total of 28 RCTs, all enrolling people with type 1 diabetes, were included. HCL systems significantly increased TIR compared with subcutaneous insulin therapy without continuous glucose monitoring (SIT). Minimed 780G achieved the highest TIR ahead of Control IQ (mean difference (MD) 5.1%, 95% confidence interval (95% CI) [0.68; 9.52], low certainty), Minimed 670G (MD 7.48%, 95% CI [4.27; 10.7], moderate certainty), CamAPS Fx (MD 8.94%, 95% CI [4.35; 13.54], low certainty), and DBLG1 (MD 10.69%, 95% CI [5.73; 15.65], low certainty). All HCL systems decreased time below target range, with DBLG1 (MD −3.69%, 95% CI [−5.2; −2.19], high certainty), Minimed 670G (MD −2.9%, 95% CI [−3.77; −2.04], moderate certainty) and Minimed 780G (MD −2.79%, 95% CI [−3.94; −1.64], high certainty) exhibiting the largest reductions compared to SIT. The risk of severe hypoglycaemia and diabetic ketoacidosis was similar to other types of insulin therapy.ConclusionsWe show a hierarchy of efficacy among the different HCL systems in people with type 1 diabetes, thus providing support to clinical decision‐making.Trial Registration: PROSPERO CRD42023453717

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Real‐world use of Control‐IQ™ technology automated insulin delivery in pregnancy: A case series with qualitative interviews

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Cited by 15 publications

References 28 publications

Use of Advanced Hybrid Closed-Loop System during Pregnancy: Strengths and Limitations of Achieving a Tight Glycemic Control

Use of Advanced Hybrid Closed-Loop System during Pregnancy: Strengths and Limitations of Achieving a Tight Glycemic Control

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

Efficacy and Safety of Different Hybrid Closed Loop Systems for Automated Insulin Delivery in People With Type 1 Diabetes: A Systematic Review and Network Meta‐Analysis

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