Hybrid Closed-Loop Insulin Improves Glycemic Control in T1D-Complicated Pregnancy

FRIDAY, Oct. 6, 2023 (HealthDay News) -- For pregnant women with type 1 diabetes, hybrid closed-loop insulin therapy significantly improves maternal glycemic control, according to a study published online Oct. 5 in the New England Journal of Medicine to coincide with the annual meeting of the European Association for the Study of Diabetes, held from Oct. 2 to 6 in Hamburg, Germany.

Tara T. M. Lee, M.B., B.S., from the Norfolk and Norwich University Hospitals NHS Foundation Trust in the United Kingdom, and colleagues conducted a multicenter trial involving 124 pregnant women with type 1 diabetes and a glycated hemoglobin level of at least 6.5 percent who were randomly assigned to receive standard insulin therapy or hybrid closed-loop therapy; both groups used continuous glucose monitoring. The percentage of time in the pregnancy-specific target glucose range (63 to 140 mg/dL), as measured from 16 weeks of gestation to delivery, was the primary outcome.

The researchers found that the mean percentage of time that the maternal glucose level was in the target range was 68.2 ± 10.5 and 55.6 ± 12.5 percent in the closed-loop and standard-care groups, respectively. Results for the secondary outcomes were consistent; compared with those in the standard-care group, participants in the closed-loop group spent less time in a hyperglycemic state, had more overnight time in the target range, and had lower glycated hemoglobin levels. There were no unanticipated safety problems associated with closed-loop therapy during pregnancy.

"These results support the recommendations, proposed in the guideline from the National Institute for Health Care Excellence, that hybrid closed-loop therapy should be offered to all pregnant persons with type 1 diabetes," the authors write.

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