Safety and efficacy of 24-h closed-loop insulin delivery in well-controlled pregnant women with type 1 diabetes: a randomized crossover case series.

Abstract

OBJECTIVETo evaluate the safety and efficacy of closed-loop insulin delivery in well-controlled pregnant women with type 1 diabetes treated with continuous subcutaneous insulin infusion (CSII).RESEARCH DESIGN AND METHODSA total of 12 women with type 1 diabetes (aged 32.9 years, diabetes duration 17.6 years, BMI 27.1 kg/m2, and HbA1c 6.4%) were randomly allocated to closed-loop or conventional CSII. They performed normal daily activities (standardized meals, snacks, and exercise) for 24 h on two occasions at 19 and 23 weeks’ gestation. Plasma glucose time in target (63–140 mg/dL) and time spent hypoglycemic were calculated.RESULTSPlasma glucose time in target was comparable for closed-loop and conventional CSII (median [interquartile range]: 81 [59–87] vs. 81% [54–90]; P = 0.75). Less time was spent hypoglycemic (<45 mg/dL [0.0 vs. 0.3%]; P = 0.04), with a lower low blood glucose index (2.4 [0.9–3.5] vs. 3.3 [1.9–5.1]; P = 0.03), during closed-loop insulin delivery.CONCLUSIONSClosed-loop insulin delivery was as effective as conventional CSII, with less time spent in extreme hypoglycemia.