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In pregnant women with type 1 diabetes, hybrid closed-loop insulin systems remarkably improve night-time glucose control and reduce hypoglycemia risk when compared to standard care.
As per a systematic review and meta-analysis, uisng hybrid closed-loop (HCL) insulin delivery systems may offer safer and more better glycemic control for pregnant women with type 1 diabetes mellitus (T1DM) when compared to standard care (SC). This study, the largest and most up-to-date of its kind, pooled data from randomized controlled trials (RCTs) to explore how well HCL systems perform during pregnancy—a critical time for glucose care.
Researchers executed a systematic search across major databases including PubMed, Cochrane, Embase, Web of Science, and ClinicalTrials.gov, identifying 6 relevant studies. After thorough screening and quality assessment via the Cochrane RoB 2 tool, 5 RCTs involving 274 participants were included in the final meta-analysis. While the pooled results exhibited no prominent differences between HCL systems and SC for overall time in range (TIR; mean difference [MD] 4.95%) and hemoglobin A1C (HbA1c) levels (MD 0.09%), HCL illustrated considerable advantages in several other measures.
These included greater nocturnal time in range (nTIR; MD 11.16%), reduced percentage of time with glucose <63 mg/dL (MD −0.78), time <54 mg/dL (MD −0.22), lower low blood glucose index (MD −0.30), and decreased glucose variability (glucose SD; MD −3.05). No meaningful differences were noted between groups for other secondary outcomes, such as time above 140 or 180 mg/dL, average glucose levels, rates of severe hypoglycemia, cesarean delivery, or serious adverse events.
Hence, HCL systems appear to offer superior nocturnal glycemic control and improved safety against hypoglycemia in pregnant women with T1DM, without escalating the risk of adverse outcomes. While these findings support HCL usage during pregnancy, further large-scale studies are required to substantiate its broader clinical benefits and long-term safety.
European Journal of Obstetrics & Gynecology and Reproductive Biology
Hybrid closed loop insulin therapy versus standard therapy in pregnant women with type 1 diabetes: A systematic review and meta-analysis of randomized controlled trials
Sohaira Tahir et al.
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