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Impact of artificial pancreas system on glycemic control among pregnant women with T1DM

Pregnant women with T1DM Pregnant women with T1DM
Pregnant women with T1DM Pregnant women with T1DM

The study aimed to analyze the effectiveness of artificial pancreas systems (APS) in pregnant females suffering from type 1 diabetes mellitus (T1DM) through a meta-analysis.

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Key take away

In pregnant women with type 1 diabetes mellitus, an artificial pancreas system may enhance 24-hour time in range and overnight glycemic control. Furthermore, its continuous use for 24 hours remarkably decreases the 24-hour time below range.

Background

The study aimed to analyze the effectiveness of artificial pancreas systems (APS) in pregnant females suffering from type 1 diabetes mellitus (T1DM) through a meta-analysis.

Method

Notably, 5 databases, encompassing Cochrane Library, SCOPUS, Web of Science, PubMed, and EMBASE were explored for literature on APS usage among T1DM mothers. The key endpoint was 24-hour time in range (TIR; 3.5-7.8 mmol/L). Glycemic metrics over a 24-hour (mean blood glucose [MBG], time above range [TAR], time below range [TBR]), as well as overnight time in range (TIR) and TBR were the secondary outcomes ascertained.

Result

Overall, four randomized controlled trials, encompassing 164 participants, were identified. A single study, with 16 participants, focused on the application of APS during the night, while the other three studies emphasized continuous 24-hour APS use. Using APS demonstrated a favorable impact on 24-hour TIR (standard mean difference [SMD] = 0.53, 95% confidence interval [CI] 0.25, 0.80), overnight TIR (SMD = 0.67, 95% CI 0.39, 0.95), and overnight TBR (<3.5 mmol/L; SMD = -0.49, 95% CI -0.77, -0.21) in comparison with standard care.

However, no profound difference was witnessed in 24-hour TBR, 24-hour TAR, or MBG between the study groups. Subgroup assessments were carried out, excluding the study that concentrated on overnight APS usage. These analyses revealed that the continuous 24-hour application of APS not only led to a reduction in 24-hour TIR (SMD = 0.41, 95% CI 0.12, 0.71) but also triggered a drop in 24-hour TBR (<2.8 mmol/L; SMD = -0.77, 95% CI -1.32, -0.23).

Conclusion

These findings indicate the potential for APS to enhance 24-hour TIR and nocturnal glycemic control, accompanied by a significant reduction in 24-hour TBR (2.8 mmol/L) among pregnant women battling T1DM.

Source:

Diabetes, Obesity & Metabolism

Article:

Effect of artificial pancreas system use on glycaemic control among pregnant women with type 1 diabetes mellitus: A meta-analysis of randomized controlled trials

Authors:

Mengyun Lei et al.

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