Gestational diabetes & diabetes in pregnancy
Real-world evidence of off-label use of commercially automated insulin delivery systems compared to multiple daily insulin injections in pregnancies complicated by type 1 diabetes
Authors' conclusion
In a real-world setting, HCL users gained more weight during pregnancy and had larger newborns than MDI users, while achieving similar glycemic control in terms of HbA1c and TIR.
Study context
- Population
- Pregnant women with T1D in Spain
- Participants
- 112 women
- Exposure
- Hybrid closed loop (HCL) vs MDI plus CGM
- HCLn = 59
- Outcome
- Glycemic control (HbA1c; TIR, TBR, TAR for 3.5-7.8 mmol/L) and maternal-fetal outcomes
Methodological detailsmulticentre, real-world, adjusted models
- Multicentre
- Real-world
- Adjusted models
Main finding
As reported in the abstract
HbA1c · any trimester
- No between-group difference in HbA1c in any trimester
- HCL users had longer diabetes duration and higher rates of prepregnancy care
Observational data: associations, not effects.
Further findings
| Outcome | HCL | MDI | Estimate | P value |
|---|---|---|---|---|
| Decrease in HbA1c · second trimesterGreater decrease with MDI | −2.16 ± 7.42 mmol/mol | −6.12 ± 9.06 mmol/mol | P = 0.031 | |
| Maternal weight gain during pregnancy | βadjusted 3.20 kg (95% CI 0.90–5.50) | |||
| Birthweight | βadjusted 279.0 g (95% CI 39.5–518.5) |
- Birthweight: Association disappeared when maternal weight gain or third trimester HbA1c was included in the models
TIR (3.5-7.8 mmol/L) and TAR
- Higher total insulin dose in the second trimester
- +0.13 IU/kg·day
- No difference in TIR and TAR between HCL and MDI users
Safety
| Outcome | aOR (95% CI) | |
|---|---|---|
| Macrosomia | 3.18 (1.05–9.67) | |
| 0.10.31310Adjusted odds ratio (log scale) |
- Macrosomia: Association disappeared when maternal weight gain or third trimester HbA1c was included in the models
Original publication
Real-world evidence of off-label use of commercially automated insulin delivery systems compared to multiple daily insulin injections in pregnancies complicated by type 1 diabetes. Diabetes Technol Ther. Published 28 February 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →