Clinical Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Slovenia.
Faculty of Medicine, University of Ljubljana, Slovenia.
J Diabetes Complications. 2024 Aug;38(8):108795. doi: 10.1016/j.jdiacomp.2024.108795. Epub 2024 Jun 11.
Aim The efficacy of hybrid closed-loop systems (HCLs) in managing glycemic control in pregnant women with type 1 diabetes remains inadequately characterized. We evaluated the use of the Medtronic Minimed 780G HCLs.
The retrospective observational study analyzed the glycemic and perinatal outcomes of pregnant women using the HCLs, followed at our tertiary centre. Independent t-tests were employed to compare data among trimesters based on pre-pregnancy HbA. The associations between glycemic parameters and perinatal outcomes were explored using Spearman rho.
Among the 21 women (age: 33.5 ± 4.2 years, diabetes duration: 21.2 ± 7.6 years, pre-pregnancy HbA 7.0 ± 1.1 % (52.9 ± 11.9 mmol/mol)) time in range (pTIR, 63-140 mg/dl; 3.5-7.8 mmol/l) increased progressively throughout pregnancy (trimesters: first: 64.0 ± 9.0 %; second:71.3 ± 11.8 %; third: 75.7 ± 8.1 %). Simultaneously, mean sensor glucose decreased (trimesters: first: 130 ± 10.4 mg/dl (7.2 ± 0.6 mmol/l); second: 120.9 ± 13.4 mg/dl (6.7 ± 0.7 mmol/l); third: 117.3 ± 9.1 mg/dl (6.5 ± 0.5 mmol/l)). Although a majority of women achieved the target pTIR until the third trimester, this did not consistently prevent the delivery of a large-for-gestational-age baby. Notably, one ketoacidosis event occurred, and there were no reported instances of severe hypoglycemia.
Use of the Minimed 780G HCLs enabled the attainment of recommended pregnancy glycemic targets for most women with type 1 diabetes in a real-world setting.
混合闭环系统（HCLs）在管理 1 型糖尿病孕妇血糖控制方面的疗效仍未得到充分描述。我们评估了美敦力 MiniMed 780G HCLs 的使用情况。
这项回顾性观察性研究分析了在我们的三级中心接受 HCLs 治疗的孕妇的血糖和围产期结局。基于孕前 HbA1c，采用独立 t 检验比较了不同孕期的血糖数据。使用 Spearman rho 探讨了血糖参数与围产期结局之间的关系。
在 21 名女性（年龄：33.5±4.2 岁，糖尿病病程：21.2±7.6 年，孕前 HbA1c7.0±1.1%（52.9±11.9mmol/mol））中，时间在目标范围内（pTIR，63-140mg/dl；3.5-7.8mmol/l）在整个孕期逐渐增加（孕期：第一：64.0±9.0%；第二：71.3±11.8%；第三：75.7±8.1%）。同时，平均传感器血糖降低（孕期：第一：130±10.4mg/dl（7.2±0.6mmol/l）；第二：120.9±13.4mg/dl（6.7±0.7mmol/l）；第三：117.3±9.1mg/dl（6.5±0.5mmol/l））。尽管大多数女性在孕晚期达到了 pTIR 目标，但这并不能始终防止巨大儿的分娩。值得注意的是，发生了 1 例酮症酸中毒事件，且无严重低血糖报告。
在真实环境中，使用美敦力 MiniMed 780G HCLs 可使大多数 1 型糖尿病女性达到妊娠血糖目标。
