Artificial pancreas promises to help women with type 1 diabetes when giving birth
Posted on 05 July 2018
Women living with type 1 diabetes who used an artificial pancreas when giving birth spent on average 82% of time in target glucose range.
27 women chose to use the artificial pancreas during labour and delivery, and the artificial pancreas performed well across vaginal births as well as planned and emergency caesarean sections.
These results come from further analysis of data from two recent studies looking at the use of the artificial pancreas during and after pregnancy.
Why did they do this research?
Managing glucose levels during pregnancy and labour is particularly challenging for women living with type 1 diabetes due to the huge hormonal and bodily changes. Women living with type 1 diabetes however have to try and keep their glucose levels in range to ensure a safe and healthy pregnancy and delivery.
The artificial pancreas is made up of a continuous glucose monitor (CGM), a computer program and an insulin pump that work together to deliver background insulin automatically and keep glucose levels in range. JDRF has been supporting Professor Roman Hovorka for many years at the University of Cambridge to develop and test an artificial pancreas for type 1 diabetes.
In the last few years, a team led by Professor Helen Murphy has been running small trials of the Professor Hovorka’s artificial pancreas during pregnancy and labour.
The aim of this observational study was to check whether the artificial pancreas could be a safe and suitable treatment option during and after giving birth.
What did they do?
The team previously ran two small studies of women using the artificial pancreas during pregnancy, and the women were offered the choice to continue using the artificial pancreas while giving birth.
27 of the 32 women who participated chose to continue using the artificial pancreas during and after labour, and the team looked at how well the artificial pancreas was able to keep glucose levels in range.
The artificial pancreas meant that the women’s glucose levels were on average in range 82% of the time during labour and delivery, and 83% in range shortly after giving birth. Importantly, there were no severe hypos or serious problems with the artificial pancreas technology.
What does this mean for type 1?
The results indicate that the artificial pancreas could be an effective treatment option during and shortly after labour for women living with type 1 diabetes. In addition, the women’s experiences using the artificial pancreas were broadly positive, with one commenting that:
“It just took all the worry away, to be honest.”
In their paper, the researchers highlighted the particular potential benefits of using the artificial pancreas shortly after giving birth:
“The rapid reduction in insulin requirements postpartum is difficult to predict and highly variable, so [the artificial pancreas] might be particularly useful in adjusting insulin doses in the postpartum period.”
As this was a small observational study, the researchers say that larger clinical trials with control groups are needed to test how effective the artificial pancreas is during pregnancy and labour compared with current treatment approaches. The team also called for more work to understand how women and healthcare providers will adopt this technology.
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