Pregnancy outcomes with the pregestational use of Minimed 780G compared to Minimed 640G: findings from a multicenter cohort study.

Autor: Perea V; Hospital Universitari Mútua de Terrassa, 5 Doctor Robert Sq, 08221, Terrassa, Spain. vperea@mutuaterrassa.cat., Quirós C; Hospital Universitari Mútua de Terrassa, 5 Doctor Robert Sq, 08221, Terrassa, Spain., Herrera-Arranz MT; Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain., Azriel-Mira S; Hospital Infanta Sofía, Madrid, Spain., Wägner AM; Complejo Hospitalario Universitario Insular Materno-Infantil de Canarias, Universidad de las Palmas de Gran Canaria, Gran Canaria, Spain., Beato-Vibora P; Hospital Universitario de Badajoz, Badajoz, Spain., Soldevila B; Hospital Universitari Germans Trias i Pujol, Institut de Recerca Germans Trias i Pujol (IGTP), Badalona, Spain.; CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto Carlos III, Barcelona, Spain., Barquiel B; Hospital Universitario La Paz, Madrid, Spain., Pardo RM; Hospital Universitario Juan Ramón Jiménez. Jerez de la Frontera, Cádiz, Spain., Díaz-Soto G; Hospital Clínico Universitario de Valladolid, Valladolid, Spain., Picón MJ; Hospital U. Virgen de la Victoria, IBIMA, Málaga, CIBEROBN, Madrid, Spain., Colomo N; Hospital Regional Universitario de Málaga, Málaga, Spain.; Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Málaga, Spain., Amigó J; Hospital Universitari Vall Hebrón, Barcelona, Spain., Climent E; Hospital del Mar, Barcelona, Spain., Durán-Martínez M; Department of Medicine, Faculty of Biomedical and Health Sciences, Hospital Universitario de Getafe, Universidad Europea de Madrid, Getafe, Spain., Corcoy R; CIBER-BBN, Madrid, Spain.; Hospital Universitari de la Santa Creu i Sant Pau, Barcelona, Spain., Codina M; Hospital Universitari Son Espases, Palma de Mallorca, Spain., Cuesta M; Hospital Clínico San Carlos, Madrid, Spain., Guedes BV; Complejo Hospitalario Universitario Insular Materno-Infantil de Canarias, Gran Canaria, Spain., Vinagre I; Hospital Clínic de Barcelona, 170 Villarroel St, 08036, Barcelona, Spain. ivinagre@clinic.cat.; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain. ivinagre@clinic.cat.
Jazyk: angličtina
Zdroj: Acta diabetologica [Acta Diabetol] 2024 Dec 04. Date of Electronic Publication: 2024 Dec 04.
DOI: 10.1007/s00592-024-02430-x
Abstrakt: Aim: To compare glycemic control and maternal-fetal outcomes of women with type 1 diabetes (T1D) using Minimed™ 780G (MM780G) with those women using Minimed™ 640G (MM640G) since before pregnancy.
Methods: Multicenter prospective cohort study of pregnant women with T1D in Spain. We evaluated HbA1c, time spent within (TIRp), below (TBRp) and above (TARp) the pregnancy-specific glucose range 3.5-7.8 mmol/L (63-140 mg/dL) and glucose variability (CV).
Results: Sixty-nine women were included (MM780G n = 40). At baseline, MM640G users had higher rates of severe hypoglycemia before pregnancy, without other between-group differences. The MM780G group had higher TIRp and lower TARp, TBRp and CV, but similar HbA1c in the first trimester of gestation. TBRp and CV remained significantly higher in the MM640G group throughout pregnancy. Higher HbA1c was observed in the MM780G group compared to the MM640G (6.28 ± 0.53% [45.1 ± 5.8 mmol/mol] vs. 5.97 ± 0.62 [41.8 ± 6.8], p = 0.003) in the second trimester. There were no differences in the mean change in HbA1c from the first to the third trimester of gestation between groups. MM780G users were more likely to have large-for-gestational-age infants (OR adjusted 4.85, 95% CI 1.46-16.13, p = 0.010), macrosomia (OR adjusted 12.17, 95% CI 1.49-99.72, p = 0.020) and cesarean section (OR adjusted 4.19, 95% CI 1.34-13.11, p = 0.014) than the MM640G group.
Conclusions: Pregestational use of MM780G led to an initial improvement in TIRp, but this was not sustained in the second and third trimesters, with a 4-fold increased risk of delivering a LGA infant and undergoing cesarean section compared to MM640G users.
Competing Interests: Declarations. Conflict of interest: V.P., MT.H., S.A-M., A-M.W., B.S., B.B., R, M., G.D-S., MJ.P., N.C., J.A., E.C., M.D-M., R.C., M.C., M.C., B.V. and IV have no relevant financial or nonfinancial interests to disclose. C.Q. has received speaking/consulting honoraria from: Medtronic, and Novalab. P.B-V. has received speaking/consulting honoraria from Abbott, Novo Nordisk, Medtronic, Roche, Novalab, and Lilly. The authors received no funding from any external source for the performance of the study.
(© 2024. Springer-Verlag Italia S.r.l., part of Springer Nature.)
Databáze: MEDLINE
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