Closed-Loop Insulin Delivery Safe in Pregnancy

Study finds model predictive control algorithm performance maintained throughout pregnancy

MONDAY, Jan. 31 (HealthDay News) -- Overnight closed-loop insulin delivery appears to be safe among pregnant women, according to a study published in the February issue of Diabetes Care.

Helen R. Murphy, M.D., of the University of Cambridge in the United Kingdom, and colleagues evaluated 10 pregnant women with type 1 diabetes over 24 hours during early (14.8 weeks) and late pregnancy (28.0 weeks) to assess closed-loop insulin delivery with a model predictive control (MPC) algorithm.

During closed-loop insulin delivery, the investigators found that the median plasma glucose levels were 117 mg/dL in early pregnancy and 126 mg/dL in late gestation (P = 0.72). The overnight mean plasma glucose time in target was 84 percent in early pregnancy and 100 percent in late pregnancy (P = 0.09). The overnight mean time spent hyperglycemic was 7 and 0 percent in early and late pregnancy, respectively (P = 0.25), and overnight mean time spent hypoglycemic was 0 percent in both early and late pregnancy (P = 0.18). Factors that were no different in early or late pregnancy included postprandial glucose control, glucose variability, insulin infusion rates, and continuous glucose monitoring sensor accuracy.

"Closed-loop insulin delivery was associated with nearly normoglycemia overnight, both in early and in late pregnancy, suggesting that the MPC algorithm safely adapts insulin delivery for advancing gestational age," the authors write.

The study was supported, in part, by Abbott Diabetes Care, which provided the FreeStyle Navigator continuous glucose monitoring system and sensors free of charge. Three authors disclosed financial ties with Minimed Medtronic, LifeScan, Novo Nordisk, Animas, and/or Becton Dickinson.

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