Glycaemic control and novel technology management strategies in pregestational diabetes mellitus

IntroductionPregestational diabetes (PGDM) is an increasingly common and complex condition that infers risk to both mother and infant. To prevent serious morbidity, strict glycaemic control is essential. The aim of this review is to review the glucose sensing and insulin delivering technologies currently available for women with PGDM. MethodsWe reviewed online databases for articles relating to technology use in pregnancy using a combination of keywords and MeSH headings. Relevant articles are included below. ResultsA number of technological advancements have improved care and outcomes for women with PGDM. Real time continuous glucose monitoring (rtCGM) offers clear advantages in terms of infants size and neonatal intensive care unit admissions; and further benefits are seen when combined with continuous subcutaneous insulin delivery (insulin pump) and algorithms which continuously adjust insulin levels to glucose targets (hybrid closed loop). Other advancements including flash or intermittent scanning CGM (isCGM) and stand-alone insulin pumps do not confer as many advantages for women and their infants, however they are increasingly used outside of pregnancy and many women enter pregnancy already using these devices. DiscussionThis article offers a discussion of the most commonly used technologies in pregnancy and evaluates their current and future roles.

Automated summary

Pregestational diabetes (PGDM) is a common and complex condition that poses risks to both mother and infant. Strict glucose control is essential to prevent serious complications. This review examines the available technologies for glucose sensing and insulin delivery in women with PGDM.