Faculty of Medicine University of Belgrade
Clinic for Endocrinology UCCS
Nebojša M. Lalić (1958), MD, PhD, FRCP, is currently Professor of Internal Medicine at the Faculty of Medicine, University of Belgrade as well as Director and Head of the Department for Metabolic Disorders, Intensive Treatment and Cell Therapy in Diabetes, Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center of Serbia in Belgrade.
Professor Lalic graduated in 1982 at Faculty of Medicine in Belgrade where he completed residency in Internal medicine in 1990, as well as his PhD thesis in 1993. In 1991, he was a visiting scientist at Joslin Diabetes Center, Boston, USA. The principal interest of Professor Lalic scientific work in diabetology/endocrinology has been concentrated on the relationship between insulin secretion and insulin sensitivity impairments in diabetes, and the possibilities of their therapeutic modulation. In this context, he is also intensively involved the use of new technologies, namely insulin pumps and sensors in both types of diabetes. Professor Lalic has been involved in more than 200 papers in extenso in international journals, chapters, monographies and textbooks. He has been an investigator in several national and international projects, reviewer at many international meetings or journals. From 2022, he has been elected to be Chair of IDF European Region.
Moderator of 1 Session
ORAL PRESENTATIONS SESSION
Session Type
ORAL PRESENTATIONS SESSION
Date
Sat, 25.02.2023
Room
Hall A4
Session Time
09:30 - 11:00
Chair(s)
Presenter of 1 Presentation
IS051 - The use of SAP In pregnancy: Comparison of the initiation of the treatment before and after conception (ID 945)
Presenter
Lecture Time
17:40 - 18:00
Session Type
PARALLEL SESSION
Date
Fri, 24.02.2023
Session Time
16:40 - 18:10
Room
Plenary Hall A6
Session Icon
Abstract
Abstract Body
Previous studies showed that achieving and maintaining optimal metabolic control remain a challenge during pregnancy complicated with type 1 diabetes (T1D). The International Consensus on Time in Range recommends increasing time in range (TIR) in pregnancy with T1D promptly and safely with a target glycaemia range of 3.5-7.8 mmol/L and TIR >70%.However, CONCEPTT, a large multicenter randomized controlled trial of real-time continuous glucose monitoring (CGM) before and during pregnancy with T1D, indicate that women only achieved these targets towards the end of the third trimester.. However, it is suggested that even a 5% increase in TIR is associated with clinically relevant improvements in neonatal health.
Previous trials demonstrated the safety of sensor-augmented insulin pump therapy (SAP), and its potential to improve glucose control in pregnancy, without increasing maternal hypoglycemia. Also, recent trials conducted in women with T1D who started SAP before pregnancy, including our study, showed an earlier significant reduction of HbA1c and improvement in TIR all over from prepregnancy to third trimesters.
Hybrid closed-loop insulin pumps with automated insulin delivery based on CGM readings have not been approved for use in pregnancy. However, many women use it in preconception and during pregnancy, after discussion of risks and benefits. Recently, use of artificial pancreas (AP) with a model-predictive control algorithm, in pregnancy with T1D, was associated with comparable glucose control and significantly less hypoglycemia than SAP therapy. Further trials are needed to identify suitable candidates for CGM, SAP and AP technology in pregnancy.