Closed-Loop Insulin Delivery During Pregnancy (IADIABENCEINTE)

Study Overview
=================
Brief Summary
-----------------
The imbalance of diabetes is associated with an increased risk of maternal and fetal complications. In women, it can cause abortion, hypertension, preeclampsia, and obstructed labor; in the fetus, it increases the risk of many malformations, including neurological and cardiac, fetal death in utero, intrauterine growth retardation, macrosomia, prematurity and metabolic complications. Despite the various therapeutic tools available and used during pregnancy, maintaining blood sugar levels within this narrow range remains a challenge. Automated Insulin Therapy (IA) Could Further Improve Outcomes With Continuous Glucose Monitoring and Increase Percentage of Time Spent on Target Between 63 and 140 mg/dL The objective of this observational study is to describe the clinical characteristics, metabolic data on MCG and maternal and/or fetal complications in women with T1D treated during pregnancy with an AI system available in France.

Detailed Description
-----------------
Diabetes imbalance is associated with an increased risk of maternal and fetal complications, and achieving target blood glucose levels before and during pregnancy in women with type 1 diabetes (T1DM) significantly reduces these complications. In women, it can cause abortion, hypertension, pre-eclampsia, and dystocic deliveries; in the fetus, it increases the risk of numerous malformations, including neurological and cardiac, fetal death in utero, intrauterine growth retardation, macrosomia, prematurity, and metabolic complications at birth such as neonatal hypoglycemia and hypocalcemia. The recommended glycemic targets during pregnancy are strict: HbA1c < 6.5% and time in target (between 63 and 140 mg/dL) > 70% (6). Despite the various therapeutic tools available and used during pregnancy, maintaining blood glucose within this narrow range remains a challenge. Automated insulin therapy (AI) could improve further on the results obtained with continuous glucose monitoring and increase the percentage of time spent in target between 63 and 140 mg/dL The objective of this present observational study is to describe the clinical characteristics, metabolic data on MCG and maternal and/or fetal complications in women with T1DM treated during pregnancy with an AI system available in France, whether this system is used before the beginning of the pregnancy or during it.

Official Title
-----------------
Closed-Loop Insulin Delivery in Pregnant Women With Type 1 Diabetes

Conditions
-----------------
Type 1 Diabetes

Intervention / Treatment
-----------------
* Device: Hybrid closed loop insulin delivery systems


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: aged at least 18 years had been diagnosed with type 1 diabetes before pregnancy using an hybrid closed-loop insulin delivery system before or at any time of pregnancy Exclusion Criteria: Patient opposed to the research

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 45 Years

Sexes Eligible for Study
-----------------
Female

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Intervention/Treatment |
| --- |
|Device: Hybrid closed loop insulin delivery systems|Tandem Control-IQ ; DBLG1 system ; MiniMed 780G system|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percentage time spent in the euglycaemic range specific for pregnancy (63-140 mg/dL) | Data drawn from continuous glucose monitoring systems | 12 weeks before the start of pregnancy (week 0) | 
| Percentage time spent in the euglycaemic range specific for pregnancy (63-140 mg/dL) | Data drawn from continuous glucose monitoring systems | week 0 | 
| Percentage time spent in the euglycaemic range specific for pregnancy (63-140 mg/dL) | Data drawn from continuous glucose monitoring systems | Week 14 | 
| Percentage time spent in the euglycaemic range specific for pregnancy (63-140 mg/dL) | Data drawn from continuous glucose monitoring systems | Week 26 | 
| Percentage time spent in the euglycaemic range specific for pregnancy (63-140 mg/dL) | Data drawn from continuous glucose monitoring systems | Wekk 38 | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
artificial pancreas, closed loop insulin delivery, glucose control, pregnancy, type 1 diabetes, observational study