This project took place at our Edinburgh centre which operated between 2008 and 2021.
Why do we need this research?
Type 1 diabetes can be hard to manage in pregnancy as blood glucose levels can be erratic. Although many women with type 1 diabetes have healthy pregnancies, there can be severe consequences for both mother and baby if diabetes is poorly controlled.
High blood glucose levels during pregnancy can lead to 1 in 2 babies being born overweight or obese, and 1 in 3 babies being delivered prematurely. However, if blood glucose levels go too low, this can be dangerous for the mother. We need to find new ways of helping pregnant women control their diabetes effectively.
The artificial pancreas - a more efficient way of giving insulin
Over the last few years, scientists have developed an automated way of giving patients the exact amount of insulin they need to control their type 1 diabetes. This is known as a closed-loop system; it consists of a continuous glucose monitor, an insulin pump and a computer program that essentially behaves like an artificial pancreas.
Using real-time information from the continuous glucose monitor, the computer program controls the insulin pump to adjust the amount of insulin the patient receives. This closed-loop system has been shown to help keep blood glucose levels within a healthy range in people who are not pregnant.
What’s happening in this project?
Researchers funded by Tommy’s want to see if an artificial pancreas system can also help pregnant women control type 1 diabetes. To do this, our researchers are testing a specially designed closed-loop in pregnancy (CLIP) system. As well as a continuous glucose monitor and insulin pump, the CLIP system includes a new pregnancy-specific smartphone app, which automatically adjusts the insulin dose every 12 minutes.
The team are now carrying out a randomised trial in ten hospitals around the UK to find out whether the CLIP system can increase the amount of time that blood glucose levels stay within a healthy range, and if it can help women avoid episodes of dangerously high or low glucose levels. They hope to include 124 women in the study, with half using the CLIP system and half using standard insulin pens or pumps. So far, 89 women have agreed to take part.
Our researchers also want to know whether the CLIP system can make pregnancy safer for both mother and baby. They hope it can reduce the proportion of babies that are born either too small or too large or that need to be admitted to a neonatal intensive care unit. The team will also look at whether women who use the CLIP system have fewer severe diabetes complications, and if pregnancy loss, stillbirth and neonatal death are reduced.
What difference will this project make?
This study will find out whether an artificial pancreas can help women with type 1 diabetes to control their blood glucose levels and make pregnancy safer for both them and their babies.
