Insulin Pumps in Pregnancy: Using Technology to Achieve Normoglycemia in Women with Diabetes

Castorino, Kristin; Paband, Rashid; Zisser, Howard; Jovanovič, Lois

doi:10.1007/s11892-011-0242-7

Cited by 16 publications

(5 citation statements)

References 34 publications

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“…Few drug studies have been performed in this population, and most evidence is observational. Insulin pumps are becoming a popular treatment modality, but studies have yet to prove that they are superior to multiple daily injections [38]. …”

Section: Diagnosis and Treatment Of Gdmmentioning

confidence: 99%

Gestational Diabetes and the Offspring: Implications in the Development of the Cardiorenal Metabolic Syndrome in Offspring

Garcia-Vargas¹,

Addison²,

Nistala³

et al. 2012

Cardiorenal Med

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The risk of developing type 2 diabetes and cardiovascular disease in women who had previously been diagnosed with gestational diabetes (GDM) is well established. There is increasing evidence that the offspring of women with GDM are at increased risk for the development of all components of the cardiorenal metabolic syndrome. Overall, it appears that these offspring have an increased risk for overweight/obesity, insulin resistance, higher blood pressure, renal disease, and type 2 diabetes. However, distinct differences in regional populations, lack of routine screening and treatment of GDM worldwide, and long follow-up periods for offspring represent a challenge in assessing the risk for development of these abnormalities in the offspring of women who have had GDM.

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Section: Diagnosis and Treatment Of Gdmmentioning

confidence: 99%

Gestational Diabetes and the Offspring: Implications in the Development of the Cardiorenal Metabolic Syndrome in Offspring

Garcia-Vargas¹,

Addison²,

Nistala³

et al. 2012

Cardiorenal Med

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“…CGM use throughout every trimester can provide pregnant women, their followers, and their health care The first successful use of CSII in pregnancy was reported in 1978, the same year that the Auto Syringe, the initial commercial subcutaneous insulin pump, was introduced in the United States and United Kingdom. [76][77][78][79] Since then, insulin pumps have undergone numerous iterations and improvements in design and functionality. 79 CSII delivers short-acting insulin in micro-boluses via a subcutaneously applied catheter.…”

Section: Safety and Efficacy Of Cgm In Pregnancymentioning

confidence: 99%

“…13 Despite the increased uptake and improvement in glycemic control, strong evidence for maternal and neonatal outcomes is lacking. 76,83,85,86,[89][90][91] A secondary analysis from the CONCEPTT study showed that the improved glucose control in pregnancy with use of CGM did not differ when comparing MDI vs CSII users. 87 MDI users did, however, experience more pronounced reductions in their HbA1c.…”

Section: Safety and Efficacy Of Csii In Pregnancymentioning

confidence: 99%

Leveraging technology for the treatment of type 1 diabetes in pregnancy: A review of past, current, and future therapeutic tools

Nosova

O’Malley

Dassau

et al. 2020

Journal of Diabetes

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The significant risks associated with pregnancies complicated by type 1 diabetes (T1D) were first recognized in the medical literature in the mid‐twentieth century. Stringent glycemic control with hemoglobin A1c (HbA1c) values ideally less than 6% has been shown to improve maternal and fetal outcomes. The management options for pregnant women with T1D in the modern era include a variety of technologies to support self‐care. Although self‐monitoring of blood glucose (SMBG) and multiple daily injections (MDI) are often the recommended management options during pregnancy, many people with T1D utilize a variety of different technologies, including continuous glucose monitoring (CGM), continuous subcutaneous insulin infusion (CSII), and CSII including automated delivery or suspension algorithms. These systems have yielded invaluable diagnostic and therapeutic capabilities and have the potential to benefit this understudied higher‐risk group. A recent prospective, multicenter study evaluating pregnant patients with T1D revealed that CGM significantly improves maternal glycemic parameters, is associated with fewer adverse neonatal outcomes, and minimizes burden. Outcome data for CSII, which is approved for use in pregnancy and has been utilized for several decades, remain mixed. Current evidence, although limited, for commercially available and emerging technologies for the management of T1D in pregnancy holds promise for improving patient and fetal outcomes.

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“…It causes many complications including cardiovascular diseases, nephropathy, stroke and retinopathy 1, 2. Moreover, diabetes with pregnancy is more complicated since hyperglycemia can lead to congenital malformations, preterm delivery, preeclampsia, macrosomia, shoulder dystocia, cesarean delivery and maternal mortality 3. Currently, the rapid development of continuous glucose monitoring (CGM) device brings new insights into the treatment of diabetic patients including those during pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Analyzing Complexity and Fractality of Glucose Dynamics in a Pregnant Woman with Type 2 Diabetes under Treatment

et al. 2019

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Currently, the rapid development of continuous glucose monitoring (CGM) device brings new insights into the treatment of diabetic patients including those during pregnancy. Complexity and fractality have recently under fast development for extracting information embodied in glucose dynamics measured using CGM. Although scientists have investigated the difference of complexity in glucose dynamics between diabetes and non-diabetes in order to discover better approaches for diabetes care, no one has analyzed the complexity and fractality of glucose dynamics during the process of adopting CGM to successfully treat pregnant women with type 2 diabetes. Thus, we analyzed the complexity and fractality using power spectral density (PSD), multi-scale sample entropy (MSE) and multifractal detrended fluctuation analysis (MF-DFA) in a clinical case. Our results show that (i) there exists multifractal behavior in blood glucose dynamics; (ii) the alpha stable distribution fits to the glucose increment data better than the Gaussian distribution; and (iii) the “global” complexity indicated by multiscale entropy, spectrum exponent and Hurst exponent increase and the “local” complexity indicated by multifractal spectrum decrease after the successful therapy. Our results offer findings that may bring value to health care providers for managing glucose levels of pregnant women with type 2 diabetes as well as provide scientists a reference on applying complexity and fractality in the clinical practice of treating diabetes.

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Insulin Pumps in Pregnancy: Using Technology to Achieve Normoglycemia in Women with Diabetes

Cited by 16 publications

References 34 publications

Gestational Diabetes and the Offspring: Implications in the Development of the Cardiorenal Metabolic Syndrome in Offspring

Gestational Diabetes and the Offspring: Implications in the Development of the Cardiorenal Metabolic Syndrome in Offspring

Leveraging technology for the treatment of type 1 diabetes in pregnancy: A review of past, current, and future therapeutic tools

Analyzing Complexity and Fractality of Glucose Dynamics in a Pregnant Woman with Type 2 Diabetes under Treatment

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