Controlling type 1 diabetes in pregnancy: a better way of giving insulin?

Prof Helen Murphy, Dr Sara White, Dr Anita Banerjee, Dr Anna Brackendridge, Dr Anna Reid

Our scientists are developing an ‘artificial pancreas’ to give pregnant women with type 1 diabetes the exact amount of insulin they need. They will study whether this can help to make pregnancy safer for both mother and baby.

Start: September 2018

End: August 2021

Why do we need this research?

Type 1 diabetes can be hard to manage in pregnancy as blood glucose levels can be erratic. Although many women with type 1 diabetes have healthy pregnancies, there can be severe consequences for both mother and baby if diabetes is poorly controlled.

High blood glucose levels can lead to 1 in 2 babies being born overweight or obese, and 1 in 3 babies being delivered prematurely. However, dangerously low blood glucose levels can also affect the health of the mother. We need to find ways to help mothers control their diabetes effectively.

The artificial pancreas - a more efficient way of giving insulin

Over the last few years, scientists have developed an automated way of giving patients the exact amount of insulin they need to control their type 1 diabetes. This is known as a closed-loop system; it consists of a continuous glucose monitor, an insulin pump and a computer program that essentially behaves like an artificial pancreas.

Using real-time information from the continuous glucose monitor, the computer program controls the insulin pump to adjust the amount of insulin the patient receives. In people who are not pregnant, this closed-loop system can help keep blood glucose levels within a healthy range.

What’s happening in this project?

Researchers funded by Tommy’s want to see if an artificial pancreas system can help pregnant women to control type 1 diabetes. To do this, our researchers are developing a specially designed closed-loop in pregnancy (CLIP) system. As well as a continuous glucose monitor and insulin pump, the CLIP system will include a new smartphone app that is specific for pregnancy, and automatically adjusts the insulin dose every 10–12 minutes.

The team will test this system in a trial with 124 women, where half will use the CLIP system and half will use standard insulin pens or pumps. They will see if the CLIP system can increase the amount of time that blood glucose levels stay within a healthy range, and if it can help women avoid episodes of dangerously high or low glucose levels.

Our researchers also want to know whether the CLIP system can improve the safety of pregnancy for both mother and baby. They hope it can reduce the proportion of babies that are born either too small or too large, or that need to be admitted to a neonatal intensive care unit. The team will also look at whether women who use the CLIP system have fewer severe diabetes complications, and if pregnancy loss, stillbirth and neonatal death are reduced.

What difference will this project make?

This study will find out whether an artificial pancreas can help women with type 1 diabetes to control their blood glucose levels, and make pregnancy safer for both them and their baby.

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