Diabetes Unit, Interdisciplinary Diabetes and Pregnancy Center, Niguarda CàGranda Hospital, Milan, Italy.
Diabetes Unit, Cantù Hospital, Abbiategrasso, Italy.
J Diabetes Sci Technol. 2024 Mar;18(2):402-406. doi: 10.1177/19322968221109262. Epub 2022 Jul 5.
Pregnancies of women with pregestational diabetes are at risk of after-meal glucose peaks and late after-meal hypoglycemia, particularly at breakfast. We aimed to explore the effectiveness of a specific feature of insulin pump therapy called superbolus in preventing these glucose swings.
In this retrospective observational study, we analyzed continuous glucose monitoring data of patients with type 1 diabetes in pregnancy who were advised to use superbolus to manage their breakfast. Some of the postprandial basal insulin delivery was partially reduced and delivered instead as additional insulin bolus on top of a normal bolus. Outcomes of interest were one hour after breakfast glucose levels, the time in glucose range for after breakfast period, the number of late hypoglycemic episodes.
Overall, 21 consecutive pregnant women with type 1 diabetes (mean age 34.3 ± 5.5 years, mean pregestational body mass index 23.7 ± 4.7 kg/m, HbA1c levels during pregnancy 6.1 ± 0.6%) were studied. Superbolus reduced after breakfast glucose peaks (one hour after breakfast glucose levels 130 ± 17 mg/dL vs 123 ± 10 mg/dL before and after superbolus use, respectively, = .01), improved the time in glucose range for after breakfast period (70.4% vs 50.8%, = .001), and reduced the number of late hypoglycemic episodes (3 [1-5] vs 1 [0-2], < .0001).
Superbolus was effective in avoiding after-meal glucose peaks, increased postprandial glucose time in target, without late hypoglycemia occurrence. It represents a valid option for the treatment of pregnant women with type 1 diabetes using insulin pump.
患有孕前糖尿病的女性妊娠期间存在餐后血糖峰值和餐后晚期低血糖的风险，尤其是早餐后。我们旨在探讨胰岛素泵治疗中的一种特殊功能——超脉冲，是否能有效预防这些血糖波动。
在这项回顾性观察研究中，我们分析了建议使用超脉冲来管理早餐的 1 型糖尿病妊娠患者的连续血糖监测数据。部分餐后基础胰岛素输送被部分减少，并作为额外的胰岛素脉冲输送到正常脉冲之上。感兴趣的结果是早餐后 1 小时血糖水平、早餐后期间的血糖范围时间、低血糖发作次数。
总体而言，研究了 21 名连续的 1 型糖尿病妊娠女性（平均年龄 34.3 ± 5.5 岁，平均孕前体重指数 23.7 ± 4.7kg/m2，妊娠期间 HbA1c 水平 6.1 ± 0.6%）。超脉冲降低了早餐后的血糖峰值（早餐后 1 小时血糖水平分别为 130 ± 17mg/dL 和 123 ± 10mg/dL， =.01），改善了早餐后期间的血糖范围时间（70.4%和 50.8%， =.001），并减少了低血糖发作次数（3[1-5]次和 1[0-2]次， <.0001）。
超脉冲在避免餐后血糖峰值方面是有效的，增加了餐后目标血糖时间，且无低血糖发生。对于使用胰岛素泵的 1 型糖尿病妊娠女性，这是一种有效的治疗选择。
