Abstract
Background and Aims
The tight metabolism targets of women with type 1 diabetes (T1D) during pregnancy are associated with a high frequency of hypoglycaemia which impose a significant burden on these women’s lives. Currently no commercial artificial pancreas system (APS), that could mitigate this burden, is approved during pregnancy.
Methods
A woman with 30 years of T1D underwent two subsequent pregnancies: Pregnancy one at age 35 using multiple daily injections (MDI) therapy (insulin glargine, Sanofi and insulin lispro, Eli-Lilly) with flash glucose monitoring (FGM; Abbott Libre Flash). Pregnancy 2 at age 37 using OpenAPS software algorithm in combination with established hardware (AC Combo, Roche Diabetes Care and Dexcom G5, Dexcom) using insulin (lispro, ELI-Lilly). Data on HbA1c, the woman’s hypoglycaemia perception, maternal weight development during the pregnancy, insulin doses (before, during and after pregnancy), childbirths, complications and birth weight of the children were collected from medical records, mother-child-passes and Nightscout downloads. Data were retrospectively analysed.
Results
No differences in above 6 of the 7 mentioned parameters were found. However, the first pregnancy with MDI and FGM showed severe hypoglycaemias, while in the second one (AAPS) no severe hypoglycaemia or hypoglycaemia unawareness occurred.
Conclusions
AAPS in pregnant women with T1D can improve metabolic control at reduced risk of hypoglycaemia leading to substantially improved quality of life. Pregnant women with T1D are not willing to wait for commercially available closed loop systems.
