I wrote earlier this year about the development of an artificial ovary, and now research funded by leading health charity Diabetes UK has for the first time successfully demonstrated the potential of an artificial pancreas in pregnant women with Type 1 diabetes. The research was published in Diabetes Care and was led by Dr Helen Murphy of Cambridge University.
Pregnancy poses additional risks 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. Hypoglycaemia (low blood glucose) in pregnancy is a major cause of mortality in women and two in three mothers with pre-existing diabetes have Type 1 diabetes.
The study evaluated the performance of an artificial pancreas or ‘closed-loop insulin delivery system’ in ten pregnant women with Type 1 diabetes. The researchers found the device was able to automatically provide the right amount of insulin at the right time, maintain near normal blood glucose levels and, in turn, prevent nocturnal hypoglycaemia in both early and late pregnancy.
The artificial pancreas was created by combining a continuous glucose monitor (CGM) with an insulin pump, both of which are already used separately by many people with Type 1 diabetes. Previous studies have shown improved blood glucose control and reduced hypoglycaemia with overnight use of an artificial pancreas in children with Type 1 diabetes but this is the first time it has been successfully used in pregnant women with the condition.
For women with Type 1 diabetes, self-management is particularly challenging during pregnancy due to physiological and hormonal changes. Previous studies indicate that pregnant women with the condition spend an average of ten hours a day with glucose levels outside the recommended target. These high blood glucose levels increase the risk of congenital malformation, stillbirth, neonatal death, preterm delivery, macrosomia (oversized babies) and neonatal admission.
All of which makes this discovery of great potential benefit in terms of both saving, and improving the quality of life. This was only a small scale study so what is now needed is an extension to test larger numbers of women. Then to be able to take it out of the hospital and in to the home setting where it will be most valuable.