Real-world data on the Minimed 780G advanced hybrid closed-loop system use during type 1 diabetes pregnancy : one centre observational study

Munda, Ana (author), Kovacic, Chiara (author), Pongrac Barlovič, Draženka (author)

Aim: The efficacy of hybrid closed-loop systems (HCLs) in managing glycemic control in pregnant women with type 1 diabetes remains inadequately characterized. We evaluated the use of the Medtronic Minimed 780G HCLs. Methods: The retrospective observational study analyzed the glycemic and perinatal outcomes of pregnant women using the HCLs, followed at our tertiary centre. Independent t-tests were employed to compare data among trimesters based on pre-pregnancy HbA$_{1c}$. The associations between glycemic parameters and perinatal outcomes were explored using Spearman rho. Results: Among the 21 women (age: 33.5 ± 4.2 years, diabetes duration: 21.2 ± 7.6 years, pre-pregnancy HbA$_{1c}$ 7.0 ± 1.1 % (52.9 ± 11.9 mmol/mol)) time in range (pTIR, 63–140 mg/dl; 3.5–7.8 mmol/l) increased progressively throughout pregnancy (trimesters: first: 64.0 ± 9.0 %; second:71.3 ± 11.8 %; third: 75.7 ± 8.1 %). Simultaneously, mean sensor glucose decreased (trimesters: first: 130 ± 10.4 mg/dl (7.2 ± 0.6 mmol/l); second: 120.9 ± 13.4 mg/dl (6.7 ± 0.7 mmol/l); third: 117.3 ± 9.1 mg/dl (6.5 ± 0.5 mmol/l)). Although a majority of women achieved the target pTIR until the third trimester, this did not consistently prevent the delivery of a largefor-gestational-age baby. Notably, one ketoacidosis event occurred, and there were no reported instances of severe hypoglycemia. Conclusion: Use of the Minimed 780G HCLs enabled the attainment of recommended pregnancy glycemic targets for most women with type 1 diabetes in a real-world setting.

• Language: English
• Keywords: type 1 diabetes, pregnancy, continuous glucose monitoring, closed-loop insulin delivery, automated insulin delivery, time in range, pregnancy outcomes
• Work type: Article
• Typology: 1.01 - Original Scientific Article
• Organization: MF - Faculty of Medicine
• Publication status: Published
• Publication version: Version of Record
• Year: 2024
• Number of pages: 7 str.
• Numbering: Vol. 38, iss. 8, art. 108795
• PID: 20.500.12556/RUL-159398
• UDC: 616.379
• ISSN on article: 1873-460X
• DOI: 10.1016/j.jdiacomp.2024.108795
• COBISS.SI-ID: 200991491
• Publication date in RUL: 09.07.2024

Record is a part of a journal

• Title: Journal of diabetes and its complications
• Publisher: Elsevier
• ISSN: 1873-460X
• COBISS.SI-ID: 518773785

Licences

• License: CC BY-NC 4.0, Creative Commons Attribution-NonCommercial 4.0 International
• Link: http://creativecommons.org/licenses/by-nc/4.0/
• Description: A creative commons license that bans commercial use, but the users don’t have to license their derivative works on the same terms.

Projects

• Funder: Other - Other funder or multiple funders
• Funding programme: University Medical Centre Ljubljana
• Project number: 20220126