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Insulin Therapy and Diabetic Pregnancy
1Department of Clinical and Molecular Medicine, Faculty of Medicine and Psycology, "Sapienza" University of Rome, Rome, Italy.
American Journal of Therapeutics
|November 6, 2019
Summary
New insulin technologies improve diabetes management in pregnancy. Advanced systems like closed-loop insulin delivery offer better glycemic control and enhance the quality of life for expectant mothers with diabetes.
Area of Science:
- Reproductive Endocrinology
- Metabolic Disorders
- Medical Technology
Background:
- Optimal metabolic control before and during pregnancy is crucial for reducing adverse outcomes in mothers and offspring with diabetes.
- Insulin therapy is the standard treatment for all types of diabetes.
- Emerging technologies offer enhanced options for achieving tight glucose control in pregnant individuals.
Purpose of the Study:
- To review the safety and efficacy of advanced insulin therapies and delivery systems in pregnant women with diabetes.
- To assess the impact of new technologies on glycemic control and pregnancy outcomes.
Main Methods:
- Comprehensive literature search of major databases (MEDLINE, EMBASE, Web of Science, Cochrane Library).
- Inclusion of randomized controlled trials, systematic reviews, meta-analyses, and observational studies.
- Exclusion of 40% of identified papers to ensure relevance to the study's focus.
Main Results:
- Continuous glucose monitoring (CGM) metrics like "time in range" guide diabetes management and are being evaluated in special populations.
- Sensor-augmented pump therapy has demonstrated improved pregnancy outcomes in women with type 1 diabetes.
- Closed-loop insulin delivery systems provide superior glycemic control compared to sensor-augmented pumps during pregnancy and postpartum.
Conclusions:
- Second-generation insulin analogues and automated insulin infusion systems significantly improve treatment and quality of life for pregnant women with diabetes.
- Ongoing multi-institutional efforts are focused on developing and validating pregnancy-specific artificial pancreas systems.
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