What's new in the management of type 1 diabetes in pregnancy?

Br J Hosp Med (Lond). 2022 Dec 2;83(12):1-10. doi: 10.12968/hmed.2022.0412. Epub 2022 Dec 29.

Abstract

Type 1 diabetes in pregnancy is associated with an increased risk of complications for both mother and fetus. However, managing glycaemia during pregnancy to reduce these risks is challenging, owing to changes in insulin resistance with advancing gestation, as well as increased daily variation in insulin pharmacokinetics. These factors can add significant psychological and daily self-care burden to mothers during what may already be an anxious time. Increasingly, diabetes technologies are being used during pregnancy to improve and facilitate diabetes self-care. While these can be empowering for people with type 1 diabetes, careful consideration is required in relation to how and when these can be continued safely in the inpatient setting (including acute antenatal admissions, labour and delivery) and when extra support is required from adequately trained healthcare professionals. This article describes current forms of diabetes technologies used and the latest national guidance relating to the care of type 1 diabetes in pregnancy.

Keywords: Antenatal hospital admissions; Closed-loop; Continuous glucose monitoring; Diabetes technology; Diabetic ketoacidosis; Pregnancy; Type 1 diabetes.

Publication types

  • Review

MeSH terms

  • Blood Glucose
  • Diabetes Mellitus, Type 1* / drug therapy
  • Female
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Insulin / therapeutic use
  • Insulin Infusion Systems
  • Pregnancy

Substances

  • Hypoglycemic Agents
  • Blood Glucose
  • Insulin