New Insights into Type 1 Diabetes Management in Pregnancy

Strategic Insights -

Investigators at San Paolo Hospital in Civitavecchia, Italy, have published a case series exploring the performance of an Advanced Hybrid closed Loop (AHCL) system in managing type 1 diabetes in pregnant women. The study aimed to explore the feasibility of a stricter glucose range during pregnancy, as current guidelines recommend a wide range of 63-140 mg/dl. The research found that while the AHCL system improved glycemic control, patients spent only a small fraction of time within a stricter range of 63-95 mg/dl.

Key Takeaways:

  • The study found that 11 type 1 diabetes patients using the Medtronic MiniMed 780G system with a glucose target of 100 mg/dl and active insulin time of 2 hours achieved a Time in Range (TIR) of 63-140 mg/dl, but only spent a limited amount of time within the range of 63-95 mg/dl.
  • The patients' HbA1c levels improved throughout pregnancy, with no significant changes in Time Below Range (TBR).
  • The study concluded that a stricter Time in Range (TIR) may be beneficial for pregnant women with type 1 diabetes, but larger studies are needed to explore the consequences on maternal and fetal outcomes.

Statistics:

  • The 11 patients in the study spent an average of 6, 5, and 7 hours per day below the target glucose range of 63-95 mg/dl in the 1st, 2nd, and 3rd trimesters, respectively.
  • The Time Above Range (TAR) 140 mg/dl was reduced more compared to TAR 95 mg/dl, indicating improved postprandial glucose control.
  • The study's results highlight the need for further research on the effects of a stricter glucose range on maternal and fetal well-being.

Sources:

  • NewsRx LLC. Reports from San Paolo Hospital Provide New Insights into Type 1 Diabetes (Metrics in pregnancy: is it the time for new glycaemic goals for pregnant women with type 1 diabetes? An experience with advanced hybrid closed loop). Diabetes Week. October 20, 2025; p 461.
  • Acta Diabetologica. Metrics in pregnancy: is it the time for new glycaemic goals for pregnant women with type 1 diabetes? An experience with advanced hybrid closed loop. [ cited in NewsRx LLC, 2025].