The role of technology in the care of diabetes mellitus in pregnancy: an expert review

THAYER, Sydney M; Lawlor, Megan L.; Williams, Karen

doi:10.1016/j.xagr.2023.100245

Cited by 4 publications

(4 citation statements)

References 55 publications

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“…This ever-evolving technological progress has been investigated in the perinatal care of GDM women as well. We suspect that by wider use of CGMS, new data will emerge, providing information that will allow the further improvement of current guidelines [28]. Evidence suggests that CGMSs are superior to SMBG in GDM in terms of detecting a wider glycemic variability, and hypo-and hyperglycemic episodes [29].…”

Section: Discussionmentioning

confidence: 99%

Tight versus less tight 1-hour postprandial glycemic target in women with gestational diabetes mellitus — a single-center cohort study

Kania,

Wilk,

Grabarczyk

et al. 2024

Ginekol Pol

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Section: Discussionmentioning

confidence: 99%

Tight versus less tight 1-hour postprandial glycemic target in women with gestational diabetes mellitus — a single-center cohort study

Kania,

Wilk,

Grabarczyk

et al. 2024

Ginekol Pol

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“…It could also be speculated that women provided with CGM or insulin pumps may represent women with a more complicated case of diabetes, since insulin pump treatment is often initiated in women with inadequate glycemic control, and in this study women with diabetes technology also had a longer history of diabetes. In addition, pregnant women who are relatively well-regulated as judged using HbA1c levels, but who still experience adverse neonatal outcomes, could have a history of prolonged and more severe diabetes [23]. It could be assumed that women using CGM and insulin pumps may be more inclined to have a larger caloric intake and possibly a different diet quality as CGM readings are easier to perform than using a finger prick.…”

Section: Discussionmentioning

confidence: 99%

“…Hybrid closed-loop systems represent the most recent technological advancement in diabetes care. In non-pregnant populations, closed-loop systems have been suggested to improve glycemic regulation compared with sensor-augmented insulin pumps [23,24].…”

Section: Introductionmentioning

confidence: 99%

Diabetes Technology in Pregnant Women with Type 1 Diabetes—Distribution and Effects on Glycemic Regulation and Perinatal Outcomes

Ghaur,

Grinderslev,

Leth-Møller

et al. 2024

Reprod. Med.

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Pregnancies complicated by type 1 diabetes (TID) are associated with an increased risk of obstetric and neonatal adverse outcomes. Optimal glycemic control prior to and through pregnancy is crucial to reduce complications. The use of diabetes technology is rapidly increasing. The aim of the study was to investigate the use and effects of diabetes technology in pregnant women with type 1 diabetes. A retrospective cohort study was conducted; 84 women were included in the analysis and were divided into subgroups according to their glucose monitoring method and insulin delivery method. HbA1c values declined during pregnancy in all subgroups with no significant difference between the subgroups. A difference was, however, found in birth weight z-scores. Women using a sensor and an insulin pump had larger babies compared to women without these treatment modalities. The results of the study indicate that diabetes technology, including insulin pumps and/or glucose sensors are not superior to self-monitoring blood glucose measurement and multiple daily injection insulin therapy, which is comforting in the light of the unequal access to health benefits.

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“…Upon the onset of pregnancy, the optimization of insulin infusion rates in individuals utilizing pump therapy, together with concurrent dietary adjustments, is essential to align with the physiological changes and demands of this period [72,73]. While pump therapy is frequently favored by patients and some experts throughout pregnancy, no definitive superiority of this method over multiple daily insulin injections has been validated thus far [72,79]. Moreover, closed-loop systems are yet to receive official endorsement for use during pregnancy mainly due to their inability to accommodate lower glucose targets usually applied in pregnancy [72,[80][81][82].…”

Section: Pregnancy and Lactationmentioning

confidence: 99%

A Nutritional Approach to Optimizing Pump Therapy in Type 1 Diabetes Mellitus

Gitsi,

Livadas,

Angelopoulos

et al. 2023

Nutrients

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Achieving optimal glucose control in individuals with type 1 diabetes (T1DM) continues to pose a significant challenge. While continuous insulin infusion systems have shown promise as an alternative to conventional insulin therapy, there remains a crucial need for greater awareness regarding the necessary adaptations for various special circumstances. Nutritional choices play an essential role in the efficacy of diabetes management and overall health status for patients with T1DM. Factors such as effective carbohydrate counting, assessment of the macronutrient composition of meals, and comprehending the concept of the glycemic index of foods are paramount in making informed pre-meal adjustments when utilizing insulin pumps. Furthermore, the ability to handle such situations as physical exercise, illness, pregnancy, and lactation by making appropriate adjustments in nutrition and pump settings should be cultivated within the patient–practitioner relationship. This review aims to provide healthcare practitioners with practical guidance on optimizing care for individuals living with T1DM. It includes recommendations on carbohydrate counting, managing mixed meals and the glycemic index, addressing exercise-related challenges, coping with illness, and managing nutritional needs during pregnancy and lactation. Additionally, considerations relating to closed-loop systems with regard to nutrition are addressed. By implementing these strategies, healthcare providers can better equip themselves to support individuals with T1DM in achieving improved diabetes management and enhanced quality of life.

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The role of technology in the care of diabetes mellitus in pregnancy: an expert review

Cited by 4 publications

References 55 publications

Tight versus less tight 1-hour postprandial glycemic target in women with gestational diabetes mellitus — a single-center cohort study

Tight versus less tight 1-hour postprandial glycemic target in women with gestational diabetes mellitus — a single-center cohort study

Diabetes Technology in Pregnant Women with Type 1 Diabetes—Distribution and Effects on Glycemic Regulation and Perinatal Outcomes

A Nutritional Approach to Optimizing Pump Therapy in Type 1 Diabetes Mellitus

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