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Artificial Pancreas Could Help Pregnant Diabetic Women

Study: Artificial Pancreas Makes Pregnancy Safer for Women With Type 1 Diabetes
By Nicky Broyd
WebMD Health News
Reviewed by Rob Hicks, MD

Jan. 31, 2011 -- For the first time, research has successfully demonstrated the potential benefits of an artificial pancreas in pregnant women with type 1 diabetes. It’s hoped the development, funded by Diabetes UK, could drastically reduce cases of stillbirth and mortality rates among pregnant women with the condition.

Pregnancy and Diabetes

Pregnancy poses additional risks for women with diabetes as hormonal changes make it very difficult to keep blood glucose levels within a safe range, especially at night. As a result of high blood glucose levels, babies of women with diabetes are five times as likely to be stillborn, three times as likely to die in their first months of life, and twice as likely to have a major deformity.

Hypoglycemia (low blood sugar) in pregnancy is a major cause of maternal mortality.

Strict glycemic control is more readily achievable by pregnant women with type 2 diabetes. However, researchers say there has been a disappointing lack of progress in managing type 1 diabetes in pregnancy.

Around 18.8 million people in the U.S. have been diagnosed with diabetes. The CDC says type 1 diabetes accounts for about 5% of adult cases of diabetes.

Artificial Pancreas

The pancreas produces insulin, the hormone that helps to control blood sugar levels. For this latest study, led by Helen Murphy, MD, of Cambridge University, the performance of an artificial pancreas or "closed-loop insulin delivery system" was evaluated in 10 pregnant women with type 1 diabetes. The researchers found the device was able to automatically provide the right amount of insulin at the right time, maintain near-normal blood glucose levels, and, in turn, prevent nocturnal hypoglycemia in both early and late pregnancy.

The artificial pancreas was created by combining a continuous glucose monitor (CGM) with an insulin pump, both of which are already used separately by many people with type 1 diabetes.

An insulin pump removes the need for a series of daily insulin injections. However, people with diabetes still have to test their blood glucose levels frequently and calculate the amount of insulin to take. In comparison, the "artificial pancreas" takes minute-by-minute glucose readings from interstitial fluid using a continuous glucose monitor. The signal will then be transmitted wirelessly to a handheld computer, which calculates the amount of insulin needed. That information is then sent to an insulin pump, which delivers the insulin.

Previous studies have shown improved blood glucose control and reduced hypoglycemia with overnight use of an artificial pancreas in children with type 1 diabetes, but this is the first time it has been successfully used in pregnant women with the condition.

“For women with type 1 diabetes, self-management is particularly challenging during pregnancy due to physiological and hormonal changes. Previous studies indicate that pregnant women with the condition spend an average of ten hours a day with glucose levels outside the recommended target,” Murphy says in a statement.

“These high blood glucose levels increase the risk of congenital malformation, stillbirth, neonatal death, preterm delivery, macrosomia [oversized babies], and neonatal admission. So to discover an artificial pancreas can help maintain near-normal glucose levels in these women is very promising,” she says.

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If the level is below 70 or you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

Congratulations on taking steps to manage your health.

However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.

Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

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