Impact of intensive insulin stabilisation service in pregnancy with type 1 diabetes

What is it about?

We investigated the impact of an intensive weekly service on glycaemic control in each trimester of pregnancy compared with our previous care model in pregnancies affected by T1DM. The study utilised data from Dexcom continuous glucose monitoring (CGM) reports for analysis of pregnancy-specific glycaemic data. There was an improvement in pregnancy-specific time-in-range for trimester 3 following the commencement of an intensive weekly insulin stabilization service (mean pre 49.6%, post 61.4%, p=0.042). Similar results were seen when women using hybrid closed loop technology were excluded, although statistical significance was then not reached. It was not possible to assess the effect of the intervention on the first trimester. There were no statistically significant changes in glycaemia for trimester 2.

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Why is it important?

Adverse pregnancy outcomes correlate with blood glucose levels in women with type 1 diabetes (T1DM). There is a gap between glycaemic targets and blood glucose control achieved in pregnancy. We found a clinically significant improvement in pregnancy specific time-in-range occurred in trimester 3, but not in trimester 1 or 2, following the introduction of intensive weekly clinical support.