Safety and Efficacy of 24-H Closed-Loop Insulin Delivery in Well-Controlled Pregnant Women With Type 1 Diabetes
A randomized crossover case series
- Helen R. Murphy, MD1⇓,
- Kavita Kumareswaran, MD1,
- Daniela Elleri, MD1,2,
- Janet M. Allen, RN1,
- Karen Caldwell, RN1,
- Martina Biagioni, MD1,
- David Simmons, MD3,
- David B. Dunger, MD2,
- Marianna Nodale, MSC1,
- Malgorzata E. Wilinska, PHD1,2,
- Stephanie A. Amiel, PHD4 and
- Roman Hovorka, PHD1,2
- 1Metabolic Research Laboratories and the National Institute for Health Research Cambridge Biomedical Research Center, University of Cambridge, Cambridge, U.K.
- 2Department of Pediatrics, University of Cambridge, Cambridge, U.K.
- 3Cambridge University Hospitals National Health Service Foundation Trust, Addenbrooke’s Hospital, Cambridge, U.K.
- 4Kings College Hospital, Guys, Kings, and St. Thomas’, London, U.K.
- Corresponding author: Helen R. Murphy, .
OBJECTIVE To evaluate the safety and efficacy of closed-loop insulin delivery in well-controlled pregnant women with type 1 diabetes treated with continuous subcutaneous insulin infusion (CSII).
RESEARCH DESIGN AND METHODS A total of 12 women with type 1 diabetes (aged 32.9 years, diabetes duration 17.6 years, BMI 27.1 kg/m2, and HbA1c 6.4%) were randomly allocated to closed-loop or conventional CSII. They performed normal daily activities (standardized meals, snacks, and exercise) for 24 h on two occasions at 19 and 23 weeks’ gestation. Plasma glucose time in target (63–140 mg/dL) and time spent hypoglycemic were calculated.
RESULTS Plasma glucose time in target was comparable for closed-loop and conventional CSII (81% [59–87] vs. 81% [54–90]; P = 0.75). Less time was spent hypoglycemic (<45 mg/dL [0.0 vs. 0.3%]; P = 0.04), with a lower low blood glucose index (2.4 [0.9–3.5] vs. 3.3 [1.9–5.1]; P = 0.03), during closed-loop insulin delivery.
CONCLUSIONS Closed-loop insulin delivery was as effective as conventional CSII, with less time spent in extreme hypoglycemia.
- Received July 29, 2011.
- Accepted September 21, 2011.
- © 2011 by the American Diabetes Association.
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