Approach to the Patient Using Diabetes Technology in Pregnancy

Area of Science:

• Obstetrics and Gynecology
• Endocrinology
• Medical Technology

Background:

• Diabetes in pregnancy poses risks to both mother and neonate.
• Strict glycemic control is crucial but challenging to achieve.
• Emerging technologies offer potential solutions for improved diabetes management during pregnancy.

Purpose of the Study:

• To review and evaluate current data on continuous glucose monitors (CGM) and hybrid closed-loop (HCL) insulin pumps in pregnancy.
• To assess the impact of these technologies on glycemic control and pregnancy outcomes.
• To identify current limitations and future directions for technology use in pregnant individuals with diabetes.

Main Methods:

• Systematic review of existing literature on CGM and HCL pump use in pregnancy.
• Analysis of data from randomized controlled trials and retrospective studies.
• Comparison of glycemic outcomes and complication rates associated with technology use.

Main Results:

• CGM use in type 1 diabetes (T1D) pregnancy improves glycemic control and reduces neonatal complications.
• Hybrid closed-loop (HCL) insulin pumps show promise in improving glycemic outcomes in T1D pregnancies.
• Limited data exists for CGM use in type 2 diabetes (T2D) and gestational diabetes mellitus (GDM) pregnancies, necessitating further research.

Conclusions:

• CGM and HCL insulin pumps are valuable tools for managing diabetes in pregnancy, particularly T1D.
• Achieving target glycemic ranges (TIR) is critical for reducing adverse outcomes.
• Healthcare disparities and access to technology require attention to ensure equitable benefits.