Real-world data on the Minimed 780G advanced hybrid closed-loop system use during type 1 diabetes pregnancy

Aim: The efficacy of hybrid closed-loop systems (HCLs) in managing glycemic control in pregnant women with type 1 diabetes remains inadequately characterized. We evaluated the use of the Medtronic Minimed 780G HCLs. Methods: The retrospective observational study analyzed the glycemic and perinatal outcomes of pregnant women using the HCLs, followed at our tertiary centre. Independent t-tests were employed to compare data among trimesters based on pre-pregnancy HbA$_{1c}$. The associations between glycemic parameters and perinatal outcomes were explored using Spearman rho. Results: Among the 21 women (age: 33.5 ± 4.2 years, diabetes duration: 21.2 ± 7.6 years, pre-pregnancy HbA$_{1c}$ 7.0 ± 1.1 % (52.9 ± 11.9 mmol/mol)) time in range (pTIR, 63–140 mg/dl3.5–7.8 mmol/l) increased progressively throughout pregnancy (trimesters: first: 64.0 ± 9.0 %second:71.3 ± 11.8 %third: 75.7 ± 8.1 %). Simultaneously, mean sensor glucose decreased (trimesters: first: 130 ± 10.4 mg/dl (7.2 ± 0.6 mmol/l)second: 120.9 ± 13.4 mg/dl (6.7 ± 0.7 mmol/l)third: 117.3 ± 9.1 mg/dl (6.5 ± 0.5 mmol/l)). Although a majority of women achieved the target pTIR until the third trimester, this did not consistently prevent the delivery of a largefor-gestational-age baby. Notably, one ketoacidosis event occurred, and there were no reported instances of severe hypoglycemia. Conclusion: Use of the Minimed 780G HCLs enabled the attainment of recommended pregnancy glycemic targets for most women with type 1 diabetes in a real-world setting

Gestational diabetes perception profiles based on attachment style

Aims Gestational diabetes (GDM) is a prevalent complication in pregnancy that requires effective self-management, which can be influenced by illness perceptions. Moreover, behavioral regulation can be affected by attachment styles. Thus, our study aimed to identify common GDM perception profiles and test their association with attachment styles. Methods In this cross-sectional study, 446 women completed the Relationship Questionnaire (RQ), the Brief Illness Perception Questionnaire (BIPQ), and additional items about GDM diagnosis, information, competence, adherence, behavioral change. Latent profile analysis (LPA) was conducted to determine GDM perception profiles. Multinomial logistic regression followed to calculate the association between GDM perception profiles and attachment styles. Results Three distinct profiles emerged: coping (n = 172, 38.6%)—characterized by the most positive GDM perception, burdened (n = 222, 49.8%)—indicating the emotional burden of the disease, and resourceless (n = 52, 11.7%)—reporting lack of resources (i.e. information, competence). Women with insecure attachment styles were more likely to develop a burdened GDM perception profile. Specifically, the expression of a fearful (OR = 1.184 [95%CI: 1.031.36], p = 0.016) and a preoccupied (OR = 1.154 [95%CI: 1.011.32], p = 0.037) attachment style increased the likelihood for a burdened perception profile, while a secure attachment style (OR = 10.791 [95%CI: 0.650.96], p = 0.017) decreased likelihood for developing resourceless GDM perception profile. Conclusions Three GDM perception profiles were identified and the role of attachment styles in shaping these perceptions was confirmed. Further studies are needed to investigate whether a tailored treatment approach based on the predominant attachment style could lead to more positive GDM perceptions, improved glycemic control, and better perinatal outcomes

No Indices of Increased Type 2 Diabetes Risk in Individuals with Reactive Postprandial Hypoglycemia

Reactive postprandial hypoglycemia (RPH) is an understudied condition that lacks clinical definition, knowledge of future health implications, and an understanding of precise underlying mechanisms. Therefore, our study aimed to assess the glycemic response after glucose ingestion in individuals several years after the initial evaluation of RPH and to compare glucose regulation in individuals with RPH vs. healthy volunteers. We assessed the inter- and intra-individual differences in glucose, insulin, and C-peptide concentrations during 5-h oral glucose tolerance tests (OGTTs); the surrogate markers of insulin resistance (HOMA-IR and Matsuda index); and beta-cell function (distribution index and insulinogenic index). The study included 29 subjects with RPH (all females, aged 39 (28, 46) years) and 11 sex-, age-, and body mass index (BMI)-matched controls. No biochemical deterioration of beta-cell secretory capacity and no progression to dysglycemia after 6.4 ± 4.2 years of follow-up were detected. RPH subjects were not insulin resistant, and their insulin sensitivity did not deteriorate. RPH subjects exhibited no differences in concentrations or in the shape of the glucose-insulin curves during the 5-h OGTTs compared to age- and BMI-matched controls. No increased incident type 2 diabetes risk indices were evident in individuals with RPH. This dictates the need for further research to investigate the magnitude of future diabetes risk in individuals experiencing RPH

Maternal and perinatal outcomes during the COVID-19 epidemic in pregnancies complicated by gestational diabetes

Gestational diabetes (GDM) is one of the most common complications in pregnancy, with a prevalence that continues to rise. At the time of the COVID-19 epidemic, immediate reorganisation and adjustment of the system was needed. Telemedicine support was offered in order to provide high-quality treatment to pregnant women. However, the success of the treatment is unknown. We therefore aimed to evaluate COVID-19 epidemic effects on pregnancy outcomes in GDM

Self-reported hypoglycaemia in patients treated with insulin: A large Slovenian retrospectively-prospective study

Hypoglycaemia is the major barrier for glycaemic target achievement in patients treated with insulin. The aim of the present study was to investigate real-world incidence and predictors of hypoglycaemia in insulin-treated patients