Automated Insulin Delivery (AID) in Pregnancy: Why, What, and How
For women of childbearing age, choosing an AID system can make a real difference to their health, well-being, and daily life. Did you know that the CamAPS FX app is the only one indicated for use during pregnancy? Women who use CamAPS FX during pregnancy experience better glucose control1 and less diabetes-related anxiety.2
Avoiding or minimising pronounced glucose excursions is a constant challenge for anyone living with type 1 diabetes. For those managing diabetes with multiple daily injections (MDI), such glycaemic fluctuations are often the result of excess correction boluses to treat hyperglycaemia, or emergency carbohydrates used to “rescue” a hypo.
Reasons for choosing AID therapy
AID systems adjust insulin delivery based on individual needs of the user thanks to the input from a CGM, and the calculations performed by an algorithm. By increasing and decreasing insulin delivery, the system aims to reduce glycaemic variability and to increase the time in range.
A matter of safety: by being able to predict future glucose trends, the algorithm can suspend insulin delivery and prevent hypoglycaemia. This increased safety is especially reassuring while sleeping, exercising or during pregnancy.
A matter of health: clinical evidence continues to show the improved glycaemic management of people living with type 1 diabetes on AID systems3-6. All studied population groups, including women, reduced HbA1c and increased time in range (TIR).
A matter of convenience: “less pressure”, “more freedom”, “complete peace-of-mind”, “higher quality of life” … such phrases are used by patients and caregivers to describe how AID systems have profoundly changed their daily management of type 1 diabetes.
How AID technology can speed up pregnancy planning
The goal of a hybrid closed-loop system is to help to 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 lifestyle and wellbeing of the person living with type 1 diabetes.
Women using the CamAPS FX algorithm report easier glucose management during their pregnancies.2
Increased day-to-day variability, changes in insulin sensitivity, fear of hyperglycaemia, and huge mental burden are some of the widely documented challenges faced by women living with type 1 diabetes during pregnancy7.
myLoop helps with the above challenges by automatically adjusting insulin delivery every 8 to 12 minutes based on CGM readings and glucose predictions up to 4 hours ahead, freeing up the woman from some of the effort of tightly managing diabetes.
CamAPS FX, the app designed and indicated for pregnancy
CamAPS FX – the app powering myLoop – was designed with the demanding pregnancy glucose targets in mind.
The 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.
How myLoop supports diabetes management before, during, and after pregnancy
Personal glucose target (PGT)
The personal glucose target can be set as low as 4.4 mmol/L in 0.1 mmol/L increments, which is a unique advantage of myLoop. A PGT within the pregnancy range (3.5–7.8 mmol/L)8 is key to achieving glycaemic targets during pregnancy.
Remote bolus delivery
myLoop is managed directly from the CamAPS FX smartphone app allowing to discreetly administer bolus doses. The system compensates for any potential over- or underdosing of meal boluses to keep the user in range.
Treat to target
myLoop takes care of the unexpected glucose swings typical of pregnancy. Thanks to predictive control, the algorithm calculates the insulin requirement for the next 2.5–4 hours. Furthermore, insulin delivery is adjusted every 8–12 minutes.
“Ease-off” and “Boost” modes
The “Ease-off” mode reduces insulin delivery depending on glucose levels, raises the glucose target temporarily and stops insulin delivery if the glucose level is predicted to fall below target. On the flip side, the “Boost” mode makes the algorithm more responsive increasing insulin delivery to proactively prevent or treat hyperglycaemia during pregnancy.