“Artificial pancreas” shows promise in pregnancy

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Scientists have shown how an “artificial pancreas” can help pregnant women with type 1 diabetes and say their finding could significantly reduce cases of stillbirth and death among diabetic expectant mothers.

British researchers used a so-called “closed-loop insulin delivery system” or artificial pancreas, in 10 pregnant women with Type 1 diabetes and found it provided the right amount of insulin at the right time, maintained near normal blood sugar, and prevented dangerous drops in blood sugar levels at night.

“To discover an artificial pancreas can help maintain near-normal glucose levels in these women is very promising,” said Helen Murphy of Cambridge University, who led the study.

The experimental artificial pancreas was created by combining a continuous glucose monitor, or CGM, with an insulin pump, both of which are already used separately by many people with type 1 diabetes.

Previous trials in children with the condition found that using an artificial pancreas system at night improved blood glucose control and reduced hypoglycaemia—when the level of glucose in the blood falls too low.

The bodies of type 1 diabetes sufferers become unable to properly break down sugar and if untreated, blood vessels and nerves are destroyed, organs fail and patients can die.

Pregnancy can be particularly risky for women with diabetes as hormonal changes make it very difficult to keep blood glucose levels within a safe range, especially at night.

As a result of high blood glucose levels, babies of women with diabetes are five times as likely to be stillborn, three times as likely to die in their first months of life and twice as likely to have a major deformity, the researchers said.

Data from previous studies suggest that pregnant women with type 1 diabetes spend an average of ten hours a day with glucose levels outside recommended targets, said Murphy, whose findings were published in the journal Diabetes Care.

This increases the risk of birth defects, stillbirth, neonatal death, preterm delivery, oversized babies and other complications.

Type 1 diabetes, an autoimmune disease in which the body destroys its own ability to make insulin, accounts for around 10 percent of all people with diabetes. The more common type 2 diabetes is often linked to bad diet and lack of exercise.

Iain Frame, director of research at the charity Diabetes UK, which part-funded the study, said that although it was a small and early stage trial, the results were encouraging.

“It’s a fantastic example of how existing technologies...can be adapted and developed to benefit as many people with diabetes as possible,” he said in a statement.

The researchers said more studies were now needed on larger numbers of women to validate their findings, and to see if the system could be developed for use outside of a hospital.

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(Reuters)

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