Time in range and mean glucose cut-off points for reduction of fetal outcomes in pregnant women with type 1 diabetes using automated insulin delivery systems
Authors' conclusion
TIRp > 59.1 % and mean glucose < 133 mg/dl in the second trimester, is associated with lower fetal outcomes of large for gestational age. One of the strategies that would improve TIRp is the early use of AHCL systems. Further studies are needed before a strong recommendation can be made.
Study context
- Population
- Pregnant women with T1D using automated insulin delivery (AID) systems, followed up in Latin America; mean age 31.9 ± 5.9 years, HbA1c 7.57 %±1.29 %, TIRp 59.8 %±14.6 %; 27.5 % on AHCL
- Participants
- 62 women
- Exposure
- TIRp <59.1% vs ≥59.1%
- Outcome
- Optimal TIRp and mean glucose cut-off points for predicting large for gestational age (LGA) (Liu method)
Methodological detailsLatin America
- Latin America
Main finding
As reported in the abstract
Cut-offs for predicting LGA · second trimester
Optimal TIRp cut-off
< 59.1 %
sensitivity 75 %, specificity 61 %; AUC 0.68, CI 0.48–0.88
Optimal mean glucose cut-off
133 mg/dL
sensitivity 69 %, specificity 70 %; AUC 0.70, CI 0.51–0.88
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| LGAMore common with TIRp < 59.1 % (50 vs 17.9 %) | P = 0.010 |
| HyperbilirubinemiaMore common with TIRp < 59.1 % (45 % vs 11.8 %) | P = 0.016 |
Metabolic control, third trimester
- Better metabolic control in AHCL users vs other devices
Original publication
Time in range and mean glucose cut-off points for reduction of fetal outcomes in pregnant women with type 1 diabetes using automated insulin delivery systems. Diabetes Res Clin Pract. Published 21 October 2024. doi:10.
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