Scientists have discovered that ‘hybrid closed-loop technology’ is more effective in aiding pregnant women with type 1 diabetes in regulating their glucose levels, as opposed to conventional techniques. The technology dynamically alters insulin doses at intervals of 10-12 minutes, relying on real-time glucose readings. According to a study, females utilizing this system experienced improved glucose regulation throughout their pregnancy and had fewer complications as well as less antenatal appointments.
Scholars at the University of East Anglia advocate for the use of automated insulin dispensing for expectant women suffering from type 1 diabetes. This technology, known as ‘hybrid closed-loop technology,’ utilizes a smartphone-based algorithm to manage insulin dispensing.
Recent research suggests that this technology is more proficient in helping pregnant women manage their glucose levels compared to existing insulin pumps or multiple daily insulin injections.
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Commentary from the Principal Investigator
Principal Investigator Prof Helen Murphy, from the University of East Anglia’s Norwich Medical School, stated: “Despite advancements in glucose monitoring and insulin delivery systems, most women find it challenging to achieve recommended glucose targets during pregnancy due to dietary alterations and hormonal changes. Consequently, complications related to type 1 diabetes during gestation are common, affecting approximately one out of every two newborns. These complications can include premature birth, admission to neonatal intensive care, and increased risk of obesity later in life for the child. Mothers commonly experience low blood sugar, excess weight gain, and high blood pressure during pregnancy. Our aim was to explore how automated insulin dispensing could ameliorate these issues.”
Details and Findings of the Study
The researchers employed a technology termed as Hybrid Closed-Loop or Artificial Pancreas. This technology comprises an algorithm embedded in a smartphone that interfaces with traditional continuous glucose monitoring and insulin pump systems.
The technology adjusts insulin doses at 10-12 minute intervals based on fluctuating glucose levels, thereby providing continuous adaptive responses throughout the pregnancy.
This technology was compared with traditional methods where insulin dosing decisions are made multiple times daily by specialist diabetes maternity teams. The study involved 124 expectant women aged between 18 and 45 years who were on daily insulin treatment. They were randomly assigned to either the hybrid closed-loop technology group or the traditional insulin therapy group.
The research was conducted across nine NHS hospitals in the United Kingdom and lasted for roughly 24 weeks, starting from 10-12 weeks into the pregnancy. The Norwich Clinical Trials Unit and the Jaeb Center for Health Research supported the study.
On average, the participants used the hybrid closed-loop system more than 95% of the time during the study period.
Prof Murphy added: “We observed a substantial improvement in maternal glucose levels throughout the pregnancy. The women using the technology spent more time within the recommended glucose range compared to those using traditional methods—68% versus 56%, equivalent to an additional 2.5 to 3 hours per day. The technology could be safely initiated during the first trimester and showed consistent improvements across all age groups, regardless of their prior glucose levels or insulin therapy.”
The study also revealed that the women using this technology gained approximately 3.5 kg less weight and had fewer blood pressure complications during their pregnancy.
Wider Implications
Significantly, the technology also reduced the number of antenatal clinic visits and after-hours consultations with maternity teams, indicating that this system could potentially save time for both expectant mothers and already stretched maternity services.
“For several years, minimal advancements have been made in enhancing glucose levels for pregnant women with type 1 diabetes. This study offers a promising new option,” said Prof Murphy.
The study also emphasized the heightened sensitivity of unborn children to minor increases in maternal glucose levels, noting that maintaining glucose levels within a normal range is critical for reducing risks to both the mother and child.
Limitations of the Study
It is important to note that the study had some limitations. These include the small sample size, which did not allow for extensive evaluation of neonatal health outcomes. Additionally, the findings are specific to CamAPS technology and cannot be generalized to other closed-loop systems with differing glucose targets that may not be suitable for use during pregnancy.
Reference: “Automated Insulin Delivery in Women with Pregnancy Complicated by Type 1 Diabetes” appeared in the New England Journal of Medicine, with DOI 10.1056/NEJMoa2303911. The research received funding from various sources including the Efficacy and Mechanism Evaluation (EME) Program, an MRC and NIHR partnership, and was further supported by other foundations.
The views conveyed in this publication are those of the authors and do not necessarily reflect the views of funding bodies like the Medical Research Council (MRC), National Institute for Health and Care Research (NIHR), or the Department of Health and Social Care.
The study was executed in collaboration with multiple research organizations, including Norfolk and Norwich University Hospitals NHS Foundation Trust, the University of Cambridge, the University of Leeds, the University of Glasgow, and others. The findings were also presented at the European Association for the Study of Diabetes (EASD) meeting.
Frequently Asked Questions (FAQs) about Hybrid Closed-Loop Technology for Pregnant Women with Type 1 Diabetes
What is the new technology discussed in the article?
The article discusses a new system known as ‘hybrid closed-loop technology’ or Artificial Pancreas. This technology dynamically adjusts insulin doses for pregnant women with type 1 diabetes at intervals of 10-12 minutes based on real-time glucose readings.
Who conducted the research on this technology?
The research was conducted by scholars at the University of East Anglia, led by Principal Investigator Prof Helen Murphy from the university’s Norwich Medical School. It involved collaboration with multiple research organizations and NHS hospitals across the United Kingdom.
What are the advantages of using this technology over traditional methods?
The technology has been shown to substantially improve maternal glucose levels throughout pregnancy. Compared to traditional methods of insulin delivery, women using this technology spent more time within the recommended glucose range—68% versus 56%, which equates to an additional 2.5 to 3 hours per day. Moreover, there was a reduction in maternal weight gain and fewer blood pressure complications.
Was the technology safe for use throughout the entire pregnancy?
Yes, the technology could be safely initiated during the first trimester of pregnancy, a crucial period for the baby’s development. It showed consistent improvements in maternal glucose levels across all age groups and regardless of prior glucose levels or insulin therapy methods.
Were there any limitations to the study?
Yes, the study had some limitations. The sample size was relatively small, which prevented a detailed examination of neonatal health outcomes. Additionally, the findings are specific to the CamAPS technology and cannot be generalized to other closed-loop systems with differing glucose targets.
What is the broader impact of this technology?
The technology not only helps in better glucose management for expectant mothers but also reduces the number of antenatal clinic visits and after-hours consultations. This suggests that the system could potentially save time for both pregnant women and maternity services, which are often stretched for resources.
Who funded the research?
The research was funded by the Efficacy and Mechanism Evaluation (EME) Program, an MRC and NIHR partnership. It was also supported by the Juvenile Diabetes Research Foundation (JDRF) and the Diabetes Research & Wellness Foundation (DRWF).
What are the potential risks if blood sugar is not managed well during pregnancy?
Poorly managed blood sugar during pregnancy can result in complications affecting one in every two newborns. These complications can include premature birth, a need for neonatal intensive care, and an increased lifelong risk of overweight and obesity for the child. For the mothers, risks include low blood sugar, excess weight gain, and high blood pressure.
Was the research presented in any scientific meetings?
Yes, the research was presented at the European Association for the Study of Diabetes (EASD) meeting.
Do the views expressed in the publication reflect those of the funding organizations?
The views conveyed in the publication are those of the authors and do not necessarily reflect the views of funding bodies like the Medical Research Council (MRC), National Institute for Health and Care Research (NIHR), or the Department of Health and Social Care.
More about Hybrid Closed-Loop Technology for Pregnant Women with Type 1 Diabetes
- University of East Anglia Research Publications
- New England Journal of Medicine: Automated Insulin Delivery in Women with Pregnancy Complicated by Type 1 Diabetes
- Efficacy and Mechanism Evaluation (EME) Program
- Juvenile Diabetes Research Foundation (JDRF)
- Diabetes Research & Wellness Foundation (DRWF)
- European Association for the Study of Diabetes (EASD) Meeting
- National Institute for Health and Care Research (NIHR)
- Medical Research Council (MRC)
- Department of Health and Social Care
- Norwich Clinical Trials Unit
- Jaeb Center for Health Research
8 comments
Such an important study! Blood sugar levels can be such a hassle during pregnancy. This could give a lotta women peace of mind.
Really impressive work. But I wonder how accessible this will be in terms of cost. You know, great technology often comes with a great price tag.
Funded by EME, MRC, and JDRF? looks like this project got some solid backing. No wonder they’ve made such significant progress.
truly amazing what science can do nowadays. This could really be a life-saver for many families. hats off to the team behind it.
Limitations or not, this is groundbreaking stuff. Hope the research gets the support it needs to be widely implemented.
Wow, this is big news! The possibilities this tech offers are huge. imagine not having to worry about insulin doses 24/7 during pregnancy. A game changer for sure.
Surprised to hear that it even reduces the number of antenatal appointments needed. thats like a win-win for everyone involved.
So the study was limited in size but the results are promising. How soon can we expect this tech to be available to the public? cant wait to see how it changes lives!