Management of type 1 diabetes in pregnancy: update on lifestyle, pharmacological treatment, and novel technologies for achieving glycaemic targets

Katrien Benhalima, Kaat Beunen, Sarah E. Siegelaar, Rebecca Painter, Helen R. Murphy, Denice S. Feig, Lois E. Donovan, Sarit Polsky, Elizabeth Buschur, Carol J. Levy, Yogish C. Kudva, Tadej Battelino, Lene Ringholm, Elisabeth R. Mathiesen, Chantal Mathieu

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations

Abstract

Glucose concentrations within target, appropriate gestational weight gain, adequate lifestyle, and, if necessary, antihypertensive treatment and low-dose aspirin reduces the risk of pre-eclampsia, preterm delivery, and other adverse pregnancy and neonatal outcomes in pregnancies complicated by type 1 diabetes. Despite the increasing use of diabetes technology (ie, continuous glucose monitoring and insulin pumps), the target of more than 70% time in range in pregnancy (TIRp 3·5–7·8 mmol/L) is often reached only in the final weeks of pregnancy, which is too late for beneficial effects on pregnancy outcomes. Hybrid closed-loop (HCL) insulin delivery systems are emerging as promising treatment options in pregnancy. In this Review, we discuss the latest evidence on pre-pregnancy care, management of diabetes-related complications, lifestyle recommendations, gestational weight gain, antihypertensive treatment, aspirin prophylaxis, and the use of novel technologies for achieving and maintaining glycaemic targets during pregnancy in women with type 1 diabetes. In addition, the importance of effective clinical and psychosocial support for pregnant women with type 1 diabetes is also highlighted. We also discuss the contemporary studies examining HCL systems in type 1 diabetes during pregnancies.

Original languageEnglish
Pages (from-to)490-508
Number of pages19
JournalThe Lancet Diabetes and Endocrinology
Volume11
Issue number7
DOIs
StatePublished - Jul 2023

Fingerprint

Dive into the research topics of 'Management of type 1 diabetes in pregnancy: update on lifestyle, pharmacological treatment, and novel technologies for achieving glycaemic targets'. Together they form a unique fingerprint.

Cite this