دورية أكاديمية
Automated insulin delivery in women with pregnancy complicated by type 1 diabetes
| العنوان: | Automated insulin delivery in women with pregnancy complicated by type 1 diabetes |
|---|---|
| المؤلفون: | Lee, Tara T. M., Collett, Corinne, Bergford, Simon, Hartnell, Sara, Scott, Eleanor M., Lindsay, Robert S., Hunt, Katharine F., McCance, David R., Barnard-Kelly, Katharine, Rankin, David, Lawton, Julia, Reynolds, Rebecca M., Flanagan, Emma, Hammond, Matthew, Shepstone, Lee, Wilinska, Malgorzata E., Sibayan, Judy, Kollman, Craig, Beck, Roy, Hovorka, Roman, Murphy, Helen R., AiDAPT Collaborative Group, . |
| بيانات النشر: | Massachusetts Medical Society |
| سنة النشر: | 2023 |
| المجموعة: | University of Glasgow: Enlighten - Publications |
| الوصف: | BACKGROUND Hybrid closed-loop insulin therapy has shown promise for management of type 1 diabetes during pregnancy; however, its efficacy is unclear. METHODS In this multicenter, controlled trial, we randomly assigned pregnant women with type 1 diabetes and a glycated hemoglobin level of at least 6.5% at nine sites in the United Kingdom to receive standard insulin therapy or hybrid closed-loop therapy, with both groups using continuous glucose monitoring. The primary outcome was the percentage of time in the pregnancy-specific target glucose range (63 to 140 mg per deciliter [3.5 to 7.8 mmol per liter]) as measured by continuous glucose monitoring from 16 weeks’ gestation until delivery. Analyses were performed according to the intention-to-treat principle. Secondary outcomes included the percentage of time spent in a hyperglycemic state (glucose level >140 mg per deciliter), overnight time in the target range, the glycated hemoglobin level, and safety events. RESULTS A total of 124 participants with a mean (±SD) age of 31.1±5.3 years and a mean baseline glycated hemoglobin level of 7.7±1.2% underwent randomization. The mean percentage of time that the maternal glucose level was in the target range was 68.2±10.5% in the closed-loop group and 55.6±12.5% in the standard-care group (mean adjusted difference, 10.5 percentage points; 95% confidence interval [CI], 7.0 to 14.0; P<0.001). Results for the secondary outcomes were consistent with those of the primary outcome; participants in the closed-loop group spent less time in a hyperglycemic state than those in the standard-care group (difference, −10.2 percentage points; 95% CI, −13.8 to −6.6); had more overnight time in the target range (difference, 12.3 percentage points; 95% CI, 8.3 to 16.2), and had lower glycated hemoglobin levels (difference, −0.31 percentage points; 95% CI, −0.50 to −0.12). Little time was spent in a hypoglycemic state. No unanticipated safety problems associated with the use of closed-loop therapy during pregnancy occurred (6 instances ... |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | text |
| اللغة: | English |
| العلاقة: | https://eprints.gla.ac.uk/321370/1/321370.pdfTest; Lee, T. T. M. et al. (2023) Automated insulin delivery in women with pregnancy complicated by type 1 diabetes. New England Journal of Medicine , 389(17), pp. 1566-1578. (doi:10.1056/nejmoa2303911 ) (PMID:37796241) |
| الإتاحة: | https://doi.org/10.1056/nejmoa2303911Test https://eprints.gla.ac.uk/321370Test/ https://eprints.gla.ac.uk/321370/1/321370.pdfTest |
| رقم الانضمام: | edsbas.C6D3F5EF |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |