Use of Advanced Hybrid Closed-Loop System during Pregnancy: Strengths and Limitations of Achieving a Tight Glycemic Control
Abstract
1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Time | ICR (g) | ISF (mg/dL) | Glucose Target (mg/dL) | AIT (h) | Suspend before Low (mg/dL) |
---|---|---|---|---|---|
0.00 | 18 | 60 | 100–120 | 4 | 60 |
10.00 | 20 | 60 | 100–120 | 4 | 60 |
14.00 | 18 | 60 | 100–120 | 4 | 60 |
Weight (kg) | BMI (kg/m2) | Kcal | Carbs (g) | Protein (g) | Fat (g) | Fiber (g) | |
---|---|---|---|---|---|---|---|
Pro gestation | 52 | 19.1 | 1800 | 157 | 71 | 90 | 26 |
5th–6th week | 52.2 | 19.2 | 1800 | 165 | 78 | 92 | 24 |
7th–8th week | 53.3 | 19.6 | 1800 | 173 | 72 | 94 | 27 |
12th–13th week | 54.4 | 20 | 2000 | 178 | 85 | 99 | 25 |
18th–19th week | 57.8 | 21.2 | 2000 | 180 | 95 | 101 | 28 |
23rd–24th week | 59.4 | 21.8 | 2000 | 190 | 85 | 99 | 22 |
28th–29th week | 62 | 22.8 | 2000 | 187 | 88 | 99 | 26 |
32nd–33rd week | 65 | 23.87 | 2200 | 180 | 110 | 115 | 27 |
34th–35th week | 67 | 24.6 | 2200 | 191 | 110 | 109 | 25 |
Trimester | Mean SG (mg/dL) | CV (%) | 63–140 mg/dL (%) | <63 mg/dL (%) | <54 mg/dL (%) | >140 mg/dL (%) | Sensor Wear (%) | Smartguard Use (%) |
---|---|---|---|---|---|---|---|---|
Beginning of pregnancy | 136 | 27.8 | 50 | 4 | 0 | 46 | 74 | 0 |
First | 126 | 39 | 49 | 15 | 6 | 37 | 91 | 0 |
Second * | 121 | 28.3 | 72 | 2 | 1 | 26 | 97 | 92.5 * |
Third | 117 | 30.2 | 70 | 4 | 1 | 26 | 97 | 96.7 |
Beginning of Pregnancy (5–6th Week) | 1st Trimester (11–12th Week) | 2nd Trimester (23–24th Week) | 3rd Trimester (37–38th Week) | |
---|---|---|---|---|
HbA1c (%) | 6.6 | 6.3 | 6.2 | 6.1 |
ICR (g) | 18–20 | 16–20 | 7–12 | 7–10 |
ISF (mg/dL) | 60 | 60 | 80 | 60 |
Basal (units/day)/(%) | 15.1 (74%) | 14.2 (58%) | 7.6 (28%) | 15.5 (36%) |
Bolus (units/day)/(%) | 5.3 (26%) | 10.2 (42%) | 19.6 (72%) | 27.9 (64%) |
TDD (units/day) | 20.4 | 24.4 | 27.2 | 45.6 |
Advantages | Disadvantages | Feedback |
---|---|---|
“In general, the system has done a great job during the entire pregnancy, even though it is not programmed for pregnancy.” | “The only period I felt like the pump “is failing me” was during the last trimester when the hormonal changes were extreme…” | “Due to constant changes in insulin needs during pregnancy two factors are crucial |
“…the system is way better compared to my former regimen…” | “…it takes a while to lower a high glucose result and “fake” carbs are used as a strategy, whereas with my previous system you can intervene directly and correct it.” | 1. The medical team to review my data weekly or sooner and act immediately |
“…it does a great job at preventing hypoglycemia.” | 2. The system to be able to change the basal rates within 1–2 days and not wait longer.” |
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Share and Cite
Giannoulaki, P.; Kotzakioulafi, E.; Nakas, A.; Kontoninas, Z.; Evripidou, P.; Didangelos, T. Use of Advanced Hybrid Closed-Loop System during Pregnancy: Strengths and Limitations of Achieving a Tight Glycemic Control. J. Clin. Med. 2024, 13, 1441. https://doi.org/10.3390/jcm13051441
Giannoulaki P, Kotzakioulafi E, Nakas A, Kontoninas Z, Evripidou P, Didangelos T. Use of Advanced Hybrid Closed-Loop System during Pregnancy: Strengths and Limitations of Achieving a Tight Glycemic Control. Journal of Clinical Medicine. 2024; 13(5):1441. https://doi.org/10.3390/jcm13051441
Chicago/Turabian StyleGiannoulaki, Parthena, Evangelia Kotzakioulafi, Alexandros Nakas, Zisis Kontoninas, Polykarpos Evripidou, and Triantafyllos Didangelos. 2024. "Use of Advanced Hybrid Closed-Loop System during Pregnancy: Strengths and Limitations of Achieving a Tight Glycemic Control" Journal of Clinical Medicine 13, no. 5: 1441. https://doi.org/10.3390/jcm13051441
APA StyleGiannoulaki, P., Kotzakioulafi, E., Nakas, A., Kontoninas, Z., Evripidou, P., & Didangelos, T. (2024). Use of Advanced Hybrid Closed-Loop System during Pregnancy: Strengths and Limitations of Achieving a Tight Glycemic Control. Journal of Clinical Medicine, 13(5), 1441. https://doi.org/10.3390/jcm13051441