Trial reportDiabetes technology & therapeutics2018
Adaptability of Closed Loop During Labor, Delivery, and Postpartum: A Secondary Analysis of Data from Two Randomized Crossover Trials in Type 1 Diabetes Pregnancy.
Trial report in Diabetes technology & therapeutics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- [Hospital diabetes management (Update 2026)].Wiener klinische Wochenschrift · 2026Guideline
- Preexisting Diabetes and Pregnancy: An Endocrine Society and European Society of Endocrinology Joint Clinical Practice Guideline.The Journal of clinical endocrinology and metabolism · 2025Guideline
- Continuous Glucose Monitors and Automated Insulin Dosing Systems in the Hospital Consensus Guideline.Journal of diabetes science and technology · 2020Guideline
- Intrapartum and Early Postpartum Use of Automated Insulin Delivery in Type 1 Diabetes: A Prespecified Analysis of the CIRCUIT Randomized Controlled Trial.Diabetes care · 2026Trial
- Automated insulin delivery during the first 6 months postpartum (AiDAPT): a prespecified extension study.The lancet. Diabetes & endocrinology · 2025Trial
- Advantages and Challenges of Automated Insulin Delivery Use in Pregnancy: Physiology Considerations.Journal of diabetes science and technology · 2026Review
- Glycaemic control in labour with diabetes: GILD, a scoping study.Health technology assessment (Winchester, England) · 2025Article
- Automated Insulin Delivery for Pregnant Women With Type 1 Diabetes: Where Do We Stand?Journal of diabetes science and technology · 2024Review
- An automated insulin delivery system from pregestational care to postpartum in women with type 1 diabetes. Preliminary experience with telemedicine in 6 patients.Acta diabetologica · 2024Article
- Case Series of Use of an Automated Insulin Delivery System During Hospital Admission for Labor and Delivery.Journal of diabetes science and technology · 2024Article
- Supporting self-management in women with pre-existing diabetes in pregnancy: a mixed-methods sequential comparative case study.BMC nursing · 2024Article
- Insulin Pumps and Hybrid Close Loop Systems Within Hospital: A Scoping Review and Practical Guidance From the Joint British Diabetes Societies for Inpatient Care.Journal of diabetes science and technology · 2023Article
- Closed-loop insulin delivery in pregnant women with type 1 diabetes (CRISTAL): a multicentre randomized controlled trial - study protocol.BMC pregnancy and childbirth · 2023Article
- Closed-loop insulin delivery: update on the state of the field and emerging technologies.Expert review of medical devices · 2022Review
- AiDAPT: automated insulin delivery amongst pregnant women with type 1 diabetes: a multicentre randomized controlled trial - study protocol.BMC pregnancy and childbirth · 2022Article
- Glycaemic control and novel technology management strategies in pregestational diabetes mellitus.Frontiers in endocrinology · 2022Review
- Oral delivery of insulin with intelligent glucose-responsive switch for blood glucose regulation.Journal of nanobiotechnology · 2020Article
- Diabetes Technology in the Inpatient Setting for Management of Hyperglycemia.Endocrinology and metabolism clinics of North America · 2020Review
- Severe neonatal hypoglycaemia and intrapartum glycaemic control in pregnancies complicated by type 1, type 2 and gestational diabetes.Diabetic medicine : a journal of the British Diabetic Association · 2020Article
- Single-Hormone Artificial Pancreas Use in Diabetes: Clinical Efficacy and Remaining Challenges.Diabetes spectrum : a publication of the American Diabetes Association · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Tight glucose control during labor and delivery is recommended for pregnant women with type 1 diabetes. This can be challenging to achieve using the current treatment modalities. The automated nature of closed loop and its ability to adapt to real-time glucose levels make it well suited for use during labor, delivery, and the immediate postpartum period. We report observational data of participants from two randomized crossover trials who chose to continue using closed loop during labor, delivery, and postpartum. Labor was defined as the 24 h before delivery and postpartum as the 48 h after delivery. The glucose target range during pregnancy was 3.5-7.8 mmol/L (63-140 mg/dL) and 3.9-10 mmol/L (70-180 mg/dL) after delivery. Twenty-seven (84.4%) of the potential 32 trial participants used closed loop through labor, delivery, and postpartum. Use of closed loop was associated with 82.0% (interquartile range [IQR] 49.3, 93.0) time-in-target range during labor and delivery and a mean glucose of 6.9 ± 1.4 mmol/L (124 ± 25 mg/dL). Closed loop performed well throughout vaginal, elective, and emergency cesarean section deliveries. Postpartum, women spent 83.3% (IQR 75.2, 94.6) time-in-target range (3.9-10.0 mmol/L [70-180 mg/dL]), with a mean glucose of 7.2 ± 1.4 mmol/L (130 ± 25 mg/dL). There was no difference in maternal glucose concentration between mothers of infants with and without neonatal hypoglycemia (6.9 ± 1.6 mmol/L and 6.8 ± 1.1 mmol/L [124 ± 29 mg/dL and 122 ± 20 mg/dL] respectively; P = 0.84). Automated closed-loop insulin delivery is feasible during hospital admissions for labor, delivery, and postpartum. Larger scale studies are needed to evaluate its efficacy compared with current clinical approaches as well as understand how women and healthcare providers will adopt this technology.
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