Helen R. Murphy (United Kingdom)
University of East Anglia (UEA)
Medicine
Dr Helen Murphy is a Professor of Medicine (Diabetes and Antenatal Care) at the University of East Anglia, and a practicing clinician (Norfolk & Norwich University Hospital NHS Trust since 2015, Cambridge University NHS Foundation Trust since 2006). She runs a diabetes pregnancy research programme which aims to support women with diabetes to achieve the pregnancy glucose targets required for optimal mother and baby health outcomes. She co-led the CONCEPTT Continuous Glucose Monitoring (CGM) trial across 31 international sites. CONCEPTT demonstrated health benefits for mothers with type 1 diabetes, their newborn infants and the potential for substantial healthcare cost savings. In addition to important scientific contributions, building research infrastructure and supporting the next generation of clinical academics, data from CONCEPTT led to changes in clinical practice, such that CGM is now the recognised standard of care for pregnant women with type 1 diabetes. She works with a multidisciplinary team of diabetes and obstetric clinicians, engineers, and social scientists to develop and evaluate closed-loop insulin delivery systems, suitable for use during pregnancy. Helen also serves as clinical lead for the National Pregnancy in Diabetes (NPID) audit, which is the largest population-based study in diabetes pregnancy. Data from NPID directly informs diabetes and maternity healthcare policy. Supported by JDRF, Diabetes UK, and the NIHR, her research is changing the management of diabetes in pregnancy. Helen serves on several research committees, the editorial board for Diabetes Care, Diabetologia, and is a regular contributor to national and international scientific meetings.

Moderator of 1 Session

 Conference Calendar

PARALLEL SESSION - PREGNANCY AND DIABETES TECHNOLOGY

Session Type
Parallel Session
Date
Fri, 29.04.2022
Session Time
16:40 - 18:00
Room
Hall 113
Chair(s)

Presenter of 1 Presentation

 Conference Calendar

Is there a role for more diabetes technology use in type 2 diabetes pregnancy

Session Name
0610 - PARALLEL SESSION - PREGNANCY AND DIABETES TECHNOLOGY (ID 41)
Session Type
Parallel Session
Date
Fri, 29.04.2022
Session Time
16:40 - 18:00
Room
Hall 113
Presenter
Lecture Time
17:40 - 18:00

Abstract

Abstract Body

During 2019-20, there were 5,085 pregnancies in women with T2D and 4,175 in those with T1D, making T2D now the commonest form of pregestational diabetes in pregnancy in England and Wales. This represents a doubling in the prevalence of T2D pregnancies in the past two decades.

Compared to pregnant women with T1D, those with T2D are older, have higher BMI, with more metabolic comorbidities (hypertension, dyslipidemia) and are more likely to belong to minority ethnic groups, and live in higher deprivation areas. There were seven times more pregnancies (>40% vs <6%) among women with T2D living in the most vs least deprived communities. Fewer than one in four were taking high dose folic acid before pregnancy. Glycaemic management was also inadequate with 25% of women untreated, 50% taking metformin alone, and only 15% taking insulin (10 % metformin and insulin, 5% insulin alone) before pregnancy. Approximately one in seven pregnant women (median age 34 years) were taking ACE-inhibitors, statins (13%) or other potentially harmful therapies (7%).

Pregnant women with T2D had higher rates of perinatal death across all HbA1c categories compared to pregnant women with T1D. After adjusting for relevant confounding risk factors, an above target HbA1c after 24 weeks was associated with a four-times increased risk of perinatal death in T2D. Rates of preterm births, LGA and neonatal intensive care unit admissions are all significantly reduced in women with T2D who achieve HbA1c < 6.1% (43mmol/mol) after 24 weeks gestation (Figure 1), emphasizing the crucial importance of antenatal glucose levels during T2D pregnancy.

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