Safety and efficacy of 24-h closed-loop insulin delivery in well-controlled pregnant women with type 1 diabetes

Helen R Murphy, Kavita Kumareswaran, Daniela Elleri, Janet M Allen, Karen Caldwell, Martina Biagioni, David Simmons, David B Dunger, Marianna Nodale, Malgorzata E Wilinska, Stephanie A Amiel, Roman Hovorka

Research output: Contribution to journalArticlepeer-review

75 Citations (Scopus)

Abstract

OBJECTIVE: To 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 METHODS: A total of 12 women with type 1 diabetes (aged 32.9 years, diabetes duration 17.6 years, BMI 27.1 kg/m(2), and HbA(1c) 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.

RESULTS: Plasma 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.

CONCLUSIONS: Closed-loop insulin delivery was as effective as conventional CSII, with less time spent in extreme hypoglycemia.

Original languageEnglish
Pages (from-to)2527-2529
Number of pages3
JournalDiabetes Care
Volume34
Issue number12
DOIs
Publication statusPublished - Dec 2011

Keywords

  • Adult
  • Blood Glucose
  • Cross-Over Studies
  • Type 1 Diabetes Mellitus
  • Female
  • Humans
  • Hypoglycemia
  • Insulin
  • Insulin Infusion Systems
  • Pregnancy
  • Pregnancy in Diabetics

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