#USA #San Francisco #Diabetes Technology #diaTribe Foundation #CGM and AID

Introduction

The complexities of managing diabetes during pregnancy have led to the establishment of the first international consensus from the diaTribe Foundation. This pivotal document, released in The Lancet Diabetes & Endocrinology, seeks to bridge gaps in clinical guidance concerning the use of continuous glucose monitoring (CGM) and automated insulin delivery systems (AID) for pregnant individuals affected by type 1 diabetes (T1D), type 2 diabetes (T2D), and gestational diabetes mellitus (GDM).

Challenges in Diabetes Management During Pregnancy

Pregnancy brings unique challenges for women managing diabetes, including drastic hormonal shifts and the need for tighter glucose control. Many women utilizing CGM and AID prior to conception may find these technologies vital for navigating the complexities of diabetes management during this period. However, despite the rising adoption of these tools, there has been a notable lack of cohesive guidance, especially regarding T2D and GDM applications.

Purpose of the Consensus

The consensus titled "Application of Continuous Glucose Monitoring and Automated Insulin Delivery Technologies for Pregnant Women with Type 1 Diabetes, Type 2 Diabetes or Gestational Diabetes Mellitus" was crafted by a multidisciplinary team of experts from six continents. Its main objective is to streamline care approaches, elevate health outcomes, and reduce the burdens faced by pregnant women managing diabetes.

Key Recommendations from the Consensus

This essential document outlines 14 specific recommendations that facilitate the effective use of diabetes technology during pregnancy. Some notable suggestions include:

• - Selecting Appropriate AID Systems: Guidance is provided on choosing the right AID systems and modifying settings according to the specific physiological needs that arise during pregnancy.
• - Preconception and Postpartum Considerations: The consensus also addresses technology application not only during pregnancy but also during the preconception phase, labor, delivery, and immediate postpartum.
• - Time in Range Targets for T2D and GDM: It introduces specific CGM time-in-range objectives aimed at T2D and GDM, updating previous standards that were initially tailored for T1D.

Supporting Healthcare Providers

One of the underlying goals of the consensus is to empower members of the healthcare team who may not be well-versed in diabetes technologies, such as primary care physicians and obstetricians. By offering evidence-based recommendations, the consensus supports these providers in delivering optimal care to pregnant women affected by diabetes.

The Broader Impact

The publication of this consensus has the potential to transform the management landscape for diabetes in pregnancy, ensuring that patient care keeps pace with technological advancements. Dr. Katrien Benhalima, the endocrinologist and chair of the expert author group, emphasized the importance of this consensus in facilitating safe pregnancies for women with diabetes, stating, "It is absolutely possible to have a safe and healthy pregnancy with diabetes, and technologies can help—but these tools are often underutilized due to limited research, few devices approved for use in pregnancy, and a lack of clear guidance."

Conclusion

The diaTribe Foundation's initiative is further strengthened by collaborations with 25 notable global organizations—such as the American College of Obstetricians and Gynecologists, European Association for the Study of Diabetes, and more. This effort not only aims to improve access to diabetes technology during pregnancy but also hopes to enhance confidence among users. By ensuring informed usage of CGM and AID technologies, the foundation looks to redefine diabetes management standards and improve the quality of care for pregnant women living with diabetes.

Through this groundbreaking consensus, both expectant mothers and healthcare providers can look forward to better navigating the complexities of diabetes management during pregnancy, ultimately promoting healthier outcomes for both mothers and their children.