How to plan a pregnancy with myLoop

From counselling to prescribing, communication is key between the healthcare team and the person living with type 1 diabetes considering a pregnancy. Openly discussing diabetes therapy options early on can bring great benefits not only in terms of glucose management, but also when it comes to pregnancy outcomes and the wellbeing of the soon-to-be mother.

Family planning is essential for women living with type 1 diabetes as the risks of an unplanned pregnancy outweighs the risks of any currently available contraception option.¹

Even though pregnancy outcomes are highly variable from person to person², time spent in the pregnancy target range (TIRp) of 3.5–7.8 mmol/L (63–140 mg/dL)³ seems to be the factor that closest correlates with risks for both the mother and baby⁴. Every 5 % increase in TIR is associated with improved obstetrical and neonatal outcomes^5.

Women who fall short of achieving the pregnancy glycaemic targets are at increased risk of several of the complications associated with diabetes pregnancies such as birth defects, pre-eclampsia, polyhydramnios, and macrosomia.⁴

The goal of an AID system is to help the patient get as close to the pre-pregnancy glucose target as it may be safely possible and once pregnant, to tackle the challenges of managing diabetes in a way that minimises the disturbances to the glucose levels, as well as the impact on lifestyle and wellbeing.

The Automated Insulin Delivery (AID) system myLoop is made up of three key components that communicate with each other: a Continuous Glucose Monitoring (CGM) system, the YpsoPump insulin pump and the CamAPS FX app.

The largest to-date randomised control trial⁶ to evaluate the impact of closed-loop insulin delivery during type 1 diabetes pregnancies – the AiDAPT study – shows that AID therapy with CamAPS FX significantly improves maternal glycaemic control^6.

• Women using CamAPS FX (n=61) spent more time in the pregnancy specific target range and had lower mean glucose and lower HbA1c levels, compared to women in the control group (n=63).

• These improvements were achieved without any difference in the time spent in the hypoglycaemic ranges.

• The benefits were observed immediately after initiating CamAPS FX and were sustained over the pregnancy period.

Any person living with type 1 diabetes might benefit from the improved glucose control and convenience of an AID. In the case of women in the age of bearing children, the reasons are three-fold:

• Up to 50 % of type 1 diabetes pregnancies are unplanned.^7,8 The better the pre-conception diabetes management, the better outcomes for the woman and her future baby.

• Starting on an AID requires training and familiarisation with the system. Going through this phase prior to becoming pregnant can ease the challenges inherent of pregnancy.

• Most insulin pump contracts have a multi-year duration. Therefore, recommending an AID indicated for use during pregnancy might be the best option for these patients – whether pregnancy is in their plans today or not.