Artificial pancreas (AP) technology is achieving tight and safer glycemic control (GC) in non-pregnant T1D populations but has been insufficiently tested in pregnant T1D patients. We evaluated glucose variability (GV) in pregnant women with T1D on Continuous subcutaneous insulin infusion (CSII) during each trimester to facilitate design of future studies. Data from 17 pregnant women with T1D, age 29 ± 4 years, DOD 17.8 ± 6 years, gestational age at delivery 38.6 ±1 weeks and fetal weight 3525± 524 gms are presented. GV at initial visit and at least 2 weeks per trimester (6-8, 10-12, 21-23, 26-28, 32-34, and 36-38) and maternal/fetal outcomes were analyzed. GV indices are shown in the Table. Mean HbA1c 7.2 ± 1.3% at baseline decreased to 6.6 ± 1.2%, 5.8 ± 0.8% and 6.0 ±0.7% during 1st, 2nd and 3rd trimester respectively. Mean BMI during 1st trimester was 27.7 ± 7.3 kg/m2 and increased to 29 ± 7.7 kg/m2and 31.7 ± 7 kg/m2 during 2nd and 3rd trimesters respectively. 8 subjects had C-section, 7 preeclampsia; 3 excessive blood loss during delivery, and 1 preterm labor, polyhydramnios and maternal infection. Additionally, 4 infants were admitted to intensive care, 4 developed hypoglycemia, one was born with malformation and one with macrosomia. GV and maternal/fetal morbidity continue to be unacceptably high during pregnancy in T1D with current technologies stressing the urgent need for AP development and testing in this context.
V. Dadlani: None. G. O'Malley: None. G. Kulina: None. K. Kumari: None. D. Desjardins: None. Y.S. Xie: None. S.K. McCrady-Spitzer: None. P. Thapa: None. K. Castorino: None. J.E. Pinsker: Research Support; Self; Insulet Corporation, Dexcom, Inc., Tandem Diabetes Care, Inc. E. Dassau: Consultant; Self; Insulet Corporation. Research Support; Self; Insulet Corporation. Consultant; Self; Animas Corporation. Research Support; Self; Dexcom, Inc.. Speaker's Bureau; Self; Roche Diabetes Care Health and Digital Solutions. Research Support; Self; Roche Diabetes Care Health and Digital Solutions, Xeris Pharmaceuticals, Inc.. Consultant; Self; Eli Lilly and Company. Research Support; Self; Tandem Diabetes Care, Inc.. Other Relationship; Self; ModAGC. Research Support; Self; LifeScan, Inc., DreaMed Diabetes, Ltd. C.J. Levy: Advisory Panel; Self; Medtronic MiniMed, Inc.. Research Support; Self; Lexicon Pharmaceuticals, Inc., Dexcom, Inc.. Y.C. Kudva: None.
