期刊
LANCET DIABETES & ENDOCRINOLOGY
卷 11, 期 7, 页码 490-508出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/S2213-8587(23)00116-X
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Maintaining glucose concentrations within target, appropriate gestational weight gain, lifestyle management, and using antihypertensive treatment and low-dose aspirin if necessary can reduce the risk of complications in pregnancies complicated by type 1 diabetes. Hybrid closed-loop insulin delivery systems show promise as a treatment option during pregnancy.
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 range in pregnancy (TIRp 3 center dot 5-7 center dot 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 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.
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