Artificial Pancreas researchers led by Dr. Helen Murphy at Cambridge University have tested a closed-loop control system in 10 pregnant women with type 1 diabetes (T1D) and found it provided the right amount of insulin at the right time, maintained near normal blood sugar, and prevented dangerous drops in blood sugar levels at night. This exploratory safety study was performed in a controlled inpatient setting and was achieved by using software that enabled measurements from a continuous glucose monitor to drive delivery from an insulin pump. Pregnancy can be particularly risky for women with diabetes as hormonal changes make it very difficult to keep blood glucose levels within a safe range, especially at night. As a result of high blood glucose levels, babies of women with diabetes are five times as likely to be stillborn, three times as likely to die in their first months of life and twice as likely to have a birth defect. Data from previous studies suggest that pregnant women with type 1 diabetes spend an average of ten hours a day with glucose levels outside recommended targets and this increases the risk of congenital malformation, stillbirth, neonatal death, preterm delivery, macrosomia (oversized babies) and neonatal admission. Currently available technologies such as CGM and sensor-augmented pump therapy, and ultimately an artificial pancreas, will enable women with T1D to achieve increasingly tighter glucose control and significantly reduce the risk of complications in pregnancy.
Closed-Loop Insulin Delivery During Pregnancy Complicated by Type 1 Diabetes, Diabetes Care. 2011, 34(2):406-11.
Ramifications for Individuals with Type 1 Diabetes:
Researchers have successfully demonstrated for the first time the potential benefits of an artificial pancreas in pregnant women with type 1 diabetes. An artificial pancreas, when ultimately commercially available, could significantly reduce diabetes-related complication rates among pregnant women with the condition. Data from this study have paved the way for future research to refine closed-loop insulin delivery in pregnancy and for the reduction of complications in pregnancy associated with type 1 diabetes.
JDRF did not directly fund this study but supported development of the closed-loop control software used to link the pump and sensor in this work through grants to APP consortium member and co-author Dr. Roman Hovorka.