Medhealth Review

Diabetes Management for Pregnant Mothers

To maintain the health of both the mother and the fetus during gestation, pregnant women need proper glycemic management. Avoiding complications is the main goal, especially those brought on by hypoglycemia, which can be problematic for expectant mothers with Type 1 diabetes (T1D). The FDA has not approved the use of continuous glucose monitors or subcutaneous insulin injections during pregnancy. Alternative options must therefore be investigated.

A small cohort study of expectant women found that closed-loop insulin delivery may be useful for controlling blood glucose levels. This procedure is helpful for T1D-complicated pregnancies and is practical.

In a small study, Eyal Dassau and associates at the Harvard John A. Paulson School of Engineering and Applied Sciences tested the effect of closed-loop insulin delivery on time in a small-time range. 11 pregnant T1D women (14–32 weeks gestation) made up the study group. A 1-week run-in phase was contrasted with a 2-day closed-loop control intervention. Participants used a Dexcom G6 CGM and their own at-home insulin pump during the run-in phase. Participants switched to an institution-provided insulin pump during the following phase.

The time-in range between the run-in phase and the closed-loop control supervised sessions varied significantly, according to the results. The time-in range increased from 64 to 81.5 percent during the closed-loop phase of the run-in phase. During the supervised phase, blood glucose levels varied less. From 30.8 percent during the run-in to 16.5 percent during the supervised session, the amount of time spent in hyperglycemia (>140 mg/dL) decreased. Additionally, in supervised sessions, the time in hypoglycemia (63 mg/dL) decreased from 5.2 percent to 2 percent.

Despite being based on a very small sample, the results were encouraging for the efficient management of blood glucose levels through closed-loop control. More research is required to be certain that this method of managing type 1 diabetes during pregnancy is secure.

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