Welcome to the ATTD 2023 Interactive Program

Abstract Body

Despite increasing use of continuous glucose monitoring (CGM) and insulin pumps, the pregnancy glucose targets of >70% time in range (TIR 3.5-7.8 mmol/L, 63-140mg/dl) ) and mean glucose 6.0-6.5mmol/L (108-117mg/dl) is often only reached in the third trimester, which is too late for optimal neonatal outcomes. Outside pregnancy, hybrid closed-loop (HCL) insulin delivery systems are associated with improved glucose levels and early data for T1D pregancy suggest feasibility of use at home and in hospital settings, including after corticosteroids, and during labour/birth. The Cambridge adaptive MPC, is the first interoperable HCL android app (CamAPS® Fx) compatible with several insulin pumps (mylife YpsoPump®, DANA Diabecare RS® DANA-i®) and with Dexcom G6 sensors (G6, G7). It offers customizable personal glucose targets which can be tightened to keep pace with gestational changes in insulin pharmacokinetics and variations in insulin sensitivity and/or resistance. Randomised controlled trials are underway evaluating this and the Tandem t:slim X2®, and Medtronic 780G® HCL systems. Case reports on other systems including Diabeloop^® (Dexcom G6 with Kaleido^® insulin pump) and do-it-yourself artificial pancreas systems (DIY-APS) are available. This session will summarize the progress of ongoing HCL studies and translation into antenatal care.