Tools
ToolsMcLean, Anna, Maple-Brown, Louise and Murphy, Helen R. (2024) Technology advances in diabetes pregnancy: Right technology, right person, right time. Diabetologia, 67 (10). pp. 2103-2113. ISSN 0012-186X
Preview |
PDF (McLean_etal_2024_Diabetologia)
- Published Version
Available under License Creative Commons Attribution. Download (704kB) | Preview |
Abstract
This review outlines some of the extraordinary recent advances in diabetes technology, which are transforming the management of type 1 diabetes before, during and after pregnancy. It highlights recent improvements associated with use of continuous glucose monitoring (CGM) but acknowledges that neither CGM nor insulin pump therapy are adequate for achieving the pregnancy glucose targets. Furthermore, even hybrid closed-loop (HCL) systems that are clinically effective outside of pregnancy may not confer additional benefits throughout pregnancy. To date, there is only one HCL system, the CamAPS FX, with a strong evidence base for use during pregnancy, suggesting that the pregnancy benefits are HCL system specific. This is in stark contrast to HCL system use outside of pregnancy, where benefits are HCL category specific. The CamAPS FX HCL system has a rapidly adaptive algorithm and lower glucose targets with benefits across all maternal glucose categories, meaning that it is applicable for all women with type 1 diabetes, before and during pregnancy. For women of reproductive years living with type 2 diabetes, the relative merits of using non-insulin pharmacotherapies vs diabetes technology (dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists and sodium−glucose cotransporter 2 inhibitors) are unknown. Despite the urgent unmet need and potential benefits, studies of pharmacotherapy and technology use are extremely limited in pregnant women with type 2 diabetes. Graphical Abstract: (Figure presented.)
| Item Type: | Article |
|---|---|
| Additional Information: | Funding Information: LM-B's work was supported by an NHMRC Investigator grant (#1194698) and AM's work was supported by an NHMRC postgraduate scholarship (#1168623) and Queensland Health New Technology and Evaluation Fund (QCOS32950). The National Pregnancy in Diabetes (NPID) audit is commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit (NCA) programme funded by NHS England and the Welsh government. The audit is prepared in collaboration with NHS Digital and supported by Diabetes UK and Public Health England. HRM's work on CamAPS FX hybrid closed-loop (AiDAPT) was funded by the Efficacy and Mechanism Evaluation (EME) Programme, an MRC and NIHR partnership, with trial data management and statistical centre support from JDRF awards #22-2013-266 and #2-RSC-2019-828-M-N. The views expressed in this publication are those of the authors and not necessarily those of the MRC, NIHR or the Department of Health and Social Care. |
| Uncontrolled Keywords: | automated insulin delivery,closed-loop,continuous glucose monitoring,diabetes technology,neonatal,obstetric,pregnancy,review,type 1 diabetes,type 2 diabetes,internal medicine,endocrinology, diabetes and metabolism,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/2700/2724 |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| UEA Research Groups: | Faculty of Medicine and Health Sciences > Research Groups > Cardiovascular and Metabolic Health Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 28 Nov 2024 01:37 |
| Last Modified: | 07 Dec 2024 01:40 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/97807 |
| DOI: | 10.1007/s00125-024-06216-2 |
Downloads
Downloads per month over past year
Actions (login required)
 |
View Item |