According to new research, automated insulin administration technology could be a game changer for type 1 diabetic pregnant women. The ‘hybrid closed-loop system’ provides insulin doses based on information from a smartphone algorithm. According to the new research, it may help pregnant women manage their blood sugars better than typical insulin pumps or many daily injections.
Prof Helen Murphy of the University of East Anglia stated, ‘This technology is game changing, in that it will allow more women to have safer, healthier, more pleasant pregnancies, with the potential for lifetime benefits for their offspring.’
According to researchers at the University of East Anglia, automated insulin delivery should be made available to pregnant women with type 1 diabetes. The ‘hybrid closed-loop system’ provides insulin doses based on information from a smartphone algorithm. According to a new study, the change could help pregnant women manage their blood sugars better than typical insulin pumps or many daily injections.
“Despite better systems for monitoring blood sugars and delivering insulin, altered eating habits and hormonal changes during pregnancy mean that most women struggle to reach the recommended blood sugar targets,” said lead researcher Prof Helen Murphy of UEA’s Norwich Medical School.
We found that the technology helped to substantially reduce maternal blood sugars throughout pregnancy. This technology is game changing, in that it will allow more women to have safer, healthier, more enjoyable pregnancies, with potential for lifelong benefits for their babies.
Prof Helen Murphy
“This means that complications related to having type 1 diabetes during pregnancy are widespread, affecting one in every two new-born babies. For the baby, these include premature birth, need for intensive care after birth, and being too large at birth, which increases the lifelong risk of overweight and obesity. Low blood sugars, excess weight gain, and high blood pressure during pregnancy are common amongst mothers. We wanted to investigate how automated insulin delivery could help.”
The researchers tested a Hybrid Closed-Loop or Artificial Pancreas technology. It is made up of an algorithm that runs on a smartphone and communicates with conventional continuous glucose monitoring and insulin pump systems.
The system modifies insulin doses every 10-12 minutes based on blood sugar levels, implying that it responds to the constant variations in blood sugar levels throughout pregnancy. The researchers compared this technology to standard continuous glucose monitoring and insulin systems, in which women are assisted by specialist diabetic maternity teams in making several daily insulin dose decisions.
The study included 124 pregnant women with type 1 diabetes who were managed with daily insulin therapy. Half of the participants were assigned at random to use Hybrid Closed-Loop technology, while the other half received traditional insulin therapy (insulin pumps or multiple daily injection methods).
The study was conducted in nine NHS hospitals across England, Scotland, and Northern Ireland, and the women participated for roughly 24 weeks (from 10-12 weeks) until the end of their pregnancy. The Norwich Clinical Trials Unit and the Jaeb Center for Health Research contributed to its success. Pregnant ladies used the Hybrid Closed-Loop technology more than 95% of the time on average.
Prof Murphy said: “We found that the technology helped to substantially reduce maternal blood sugars throughout pregnancy. This technology is game changing, in that it will allow more women to have safer, healthier, more enjoyable pregnancies, with potential for lifelong benefits for their babies.”
“Compared to traditional insulin therapy methods, women who used the technology spent more time in the target range for pregnancy blood sugar levels — 68 per cent vs 56 per cent, which is equivalent to an additional two-and-a-half to three hours every day throughout pregnancy.
“It was safely initiated during the first trimester, which is a crucially important time for babies’ development. The blood sugar levels improved consistently in mothers across of all ages, and regardless of their previous blood sugar levels or previous insulin therapy. These improvements were achieved without additional low blood glucose events, and without additional insulin,” she added.
The researchers also discovered that women who used the device acquired 3.5 kg (equivalent to 7.7 lbs) less weight and were less likely to experience blood pressure issues during pregnancy. Importantly, women who used the technology had fewer antenatal clinic sessions and fewer after-hours phone contacts with maternity clinic teams, implying that this technology could save time for pregnant women and overburdened maternity facilities.
“For a long time, there has been limited progress in improving blood sugars for women with type 1 diabetes, so we’re really excited that our study offers a new option to help pregnant women manage their diabetes,” said Dr. Murphy.
“We know that unborn babies in women with type 1 diabetes are extremely sensitive to small increases in blood sugars, so keeping blood sugar levels within the normal range during pregnancy is critical to reducing risks for both mother and child.” Previous research has shown that every extra hour spent in the blood-sugar target range reduces the risks of premature birth, being too large at birth, and the need for neonatal intensive care unit hospitalization.
The researchers acknowledge some limitations, including the fact that the current study was too small to conduct a thorough examination of baby health outcomes, and that their findings are specific to the CamAPS technology and cannot be extrapolated to closed-loop systems with higher blood sugar targets, which may not be appropriate for use during pregnancy.
