ArticleActa diabetologica2026
Metrics in pregnancy: is it the time for new glycaemic goals for pregnant women with type 1 diabetes? An experience with advanced hybrid closed loop.
Article in Acta diabetologica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionRecommended pregnancy specific Time in Range (TIR) 63-140 mg/dl is a quite wide range and, even if the goal of > 70% is achieved, the specific targets for fasting and mean glycaemia, which are much lower than 140 mg/dl, could not be complied. This case series aimed to explore the performance of an Advanced Hybrid closed Loop (AHCL) in pregnancy on a stricter glycaemic range.
methodsWe collected retrospective data about recommended glucose metrics and an hypothetic TITR 63-95 mg/dl, more suitable for fasting periods, from 11 type 1 diabetes patients, using Medtronic MiniMed™ 780G, with glucose target 100 mg/dl and Active Insulin Time 2 h, from preconceptional phase until delivery.
resultsTIR 63-140 mg/dl quickly improved throughout pregnancy, with progressively improving HbA1c and no significant changes in Time Below Range (TBR). TITR 63-95 mg/dl was 26% in the 1st trimester, 20% in the 2nd and 30% in the 3rd, corresponding to 6, 5 and 7 h per day, less than the hypothetic 8/24 hours of fasting. TAR > 140 reduced more compared to TAR > 95, reflecting a greater improve in postprandial values than in fasting.
conclusionsAlthough the AHCL Medtronic MiniMed™ 780G helped improving glycaemic control during pregnancy, our patients spent very few hours in the range 63-95 mg/dl, probably because they did not reach fasting glucose goals. A stricter TIR may be hypothesized for pregnant women too, as an additional goal along with TIR 63-140 mg/dl, but studies are needed to explore the consequences on maternal and fetal outcomes.
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