Automated Insulin Delivery in Women with Pregnancy Complicated by Type 1 Diabetes.

Adult Female Humans Pregnancy Blood Glucose / analysis Blood Glucose Self-Monitoring Diabetes Mellitus, Type 1 / blood Glycated Hemoglobin / analysis Hypoglycemic Agents / administration & dosage Insulin / administration & dosage Insulin Infusion Systems / adverse effects Pregnancy in Diabetics / blood Treatment Outcome

Journal

The New England journal of medicine
ISSN: 1533-4406
Titre abrégé: N Engl J Med
Pays: United States
ID NLM: 0255562

Informations de publication

Date de publication:
26 Oct 2023
Historique:
medline: 30 10 2023
pubmed: 5 10 2023
entrez: 5 10 2023
Statut: ppublish

Résumé

Hybrid closed-loop insulin therapy has shown promise for management of type 1 diabetes during pregnancy; however, its efficacy is unclear. In this multicenter, controlled trial, we randomly assigned pregnant women with type 1 diabetes and a glycated hemoglobin level of at least 6.5% at nine sites in the United Kingdom to receive standard insulin therapy or hybrid closed-loop therapy, with both groups using continuous glucose monitoring. The primary outcome was the percentage of time in the pregnancy-specific target glucose range (63 to 140 mg per deciliter [3.5 to 7.8 mmol per liter]) as measured by continuous glucose monitoring from 16 weeks' gestation until delivery. Analyses were performed according to the intention-to-treat principle. Key secondary outcomes were the percentage of time spent in a hyperglycemic state (glucose level >140 mg per deciliter), overnight time in the target range, the glycated hemoglobin level, and safety events. A total of 124 participants with a mean (±SD) age of 31.1±5.3 years and a mean baseline glycated hemoglobin level of 7.7±1.2% underwent randomization. The mean percentage of time that the maternal glucose level was in the target range was 68.2±10.5% in the closed-loop group and 55.6±12.5% in the standard-care group (mean adjusted difference, 10.5 percentage points; 95% confidence interval [CI], 7.0 to 14.0; P<0.001). Results for the secondary outcomes were consistent with those of the primary outcome; participants in the closed-loop group spent less time in a hyperglycemic state than those in the standard-care group (difference, -10.2 percentage points; 95% CI, -13.8 to -6.6); had more overnight time in the target range (difference, 12.3 percentage points; 95% CI, 8.3 to 16.2), and had lower glycated hemoglobin levels (difference, -0.31 percentage points; 95% CI, -0.50 to -0.12). Little time was spent in a hypoglycemic state. No unanticipated safety problems associated with the use of closed-loop therapy during pregnancy occurred (6 instances of severe hypoglycemia, vs. 5 in the standard-care group; 1 instance of diabetic ketoacidosis in each group; and 12 device-related adverse events in the closed-loop group, 7 related to closed-loop therapy). Hybrid closed-loop therapy significantly improved maternal glycemic control during pregnancy complicated by type 1 diabetes. (Funded by the Efficacy and Mechanism Evaluation Program; AiDAPT ISRCTN Registry number, ISRCTN56898625.).

Sections du résumé

BACKGROUND BACKGROUND
Hybrid closed-loop insulin therapy has shown promise for management of type 1 diabetes during pregnancy; however, its efficacy is unclear.
METHODS METHODS
In this multicenter, controlled trial, we randomly assigned pregnant women with type 1 diabetes and a glycated hemoglobin level of at least 6.5% at nine sites in the United Kingdom to receive standard insulin therapy or hybrid closed-loop therapy, with both groups using continuous glucose monitoring. The primary outcome was the percentage of time in the pregnancy-specific target glucose range (63 to 140 mg per deciliter [3.5 to 7.8 mmol per liter]) as measured by continuous glucose monitoring from 16 weeks' gestation until delivery. Analyses were performed according to the intention-to-treat principle. Key secondary outcomes were the percentage of time spent in a hyperglycemic state (glucose level >140 mg per deciliter), overnight time in the target range, the glycated hemoglobin level, and safety events.
RESULTS RESULTS
A total of 124 participants with a mean (±SD) age of 31.1±5.3 years and a mean baseline glycated hemoglobin level of 7.7±1.2% underwent randomization. The mean percentage of time that the maternal glucose level was in the target range was 68.2±10.5% in the closed-loop group and 55.6±12.5% in the standard-care group (mean adjusted difference, 10.5 percentage points; 95% confidence interval [CI], 7.0 to 14.0; P<0.001). Results for the secondary outcomes were consistent with those of the primary outcome; participants in the closed-loop group spent less time in a hyperglycemic state than those in the standard-care group (difference, -10.2 percentage points; 95% CI, -13.8 to -6.6); had more overnight time in the target range (difference, 12.3 percentage points; 95% CI, 8.3 to 16.2), and had lower glycated hemoglobin levels (difference, -0.31 percentage points; 95% CI, -0.50 to -0.12). Little time was spent in a hypoglycemic state. No unanticipated safety problems associated with the use of closed-loop therapy during pregnancy occurred (6 instances of severe hypoglycemia, vs. 5 in the standard-care group; 1 instance of diabetic ketoacidosis in each group; and 12 device-related adverse events in the closed-loop group, 7 related to closed-loop therapy).
CONCLUSIONS CONCLUSIONS
Hybrid closed-loop therapy significantly improved maternal glycemic control during pregnancy complicated by type 1 diabetes. (Funded by the Efficacy and Mechanism Evaluation Program; AiDAPT ISRCTN Registry number, ISRCTN56898625.).

Identifiants

DOI: 10.1056/NEJMoa2303911 PMID: 37796241
pubmed: 37796241
doi: 10.1056/NEJMoa2303911
doi:

Substances chimiques

Blood Glucose 0
Glycated Hemoglobin 0
Hypoglycemic Agents 0
Insulin 0

Banques de données

ISRCTN
['ISRCTN56898625']

Types de publication

Comparative Study Journal Article Multicenter Study Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

1566-1578

Subventions

Organisme : Efficacy and Mechanism Evaluation Programme
ID : NIHR EME reference 16/35/01
Organisme : Juvenile Diabetes Research Foundation United States of America
ID : #2-RSC-2019-828-M-N
Organisme : Juvenile Diabetes Research Foundation United States of America
ID : #22-2013-266
Organisme : Diabetes Research and Wellness Foundation
ID : Sutherland-Earl Fellowship (reference SECF/21)

Investigateurs

Katharine Hunt (K)
Helen Rogers (H)
Damian Morris (D)
Duncan Fowler (D)
Josephine Rosier (J)
Zeenat Banu (Z)
Sarah Barker (S)
Gerry Rayman (G)
Eleanor Gurnell (E)
Caroline Byrne (C)
Andrea Lake (A)
Katy Davenport (K)
Jeannie Grisoni (J)
Shannon Savine (S)
Helen R Murphy (HR)
Tara T M Lee (TTM)
Tara Wallace (T)
Alastair McKelvey (A)
Nina Willer (N)
Elizabeth Turner (E)
Corinne Collett (C)
Mei-See Man (MS)
Emma Flanagan (E)
Matt Hammond (M)
Lee Shepstone (L)
Anna Brackenridge (A)
Sara White (S)
Anna Reid (A)
Olanike Okolo (O)
Eleanor M Scott (EM)
Del Endersby (D)
Anna Dover (A)
Frances Dougherty (F)
Susan Johnston (S)
Rebecca M Reynolds (RM)
Robert Lindsay (R)
David Carty (D)
Sharon Mackin (S)
Isobel Crawford (I)
Ross Buchan (R)
David McCance (D)
Louisa Jones (L)
Joanne Quinn (J)
Sarah Cains (S)
Goher Ayman (G)

Informations de copyright

Copyright © 2023 Massachusetts Medical Society.

Auteurs

Tara T M Lee (TTM)

From the Norfolk and Norwich University Hospitals NHS Foundation Trust (T.T.M.L., H.R.M.) and the Norwich Clinical Trials Unit (C.C., E.F., M.H., L.S.), Norwich Medical School (T.T.M.L., H.R.M.), University of East Anglia, Norwich, Cambridge University Hospitals NHS Foundation Trust (S.H.), and the Wellcome-MRC Institute of Metabolic Science, University of Cambridge (M.E.W., R.H.), Cambridge, the Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds (E.M.S.), the Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow (R.S.L.), King's College Hospital NHS Foundation Trust, London (K.F.H.), the Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast (D.R.M.), Barnard Health Research, Southampton (K.B.-K.), and the Usher Institute (D.R., J.L.) and the Centre for Cardiovascular Science (R.M.R.), University of Edinburgh, Edinburgh - all in the United Kingdom; and the Jaeb Center for Health Research, Tampa, FL (S.B., J.S., C.K., R.B.).
ORCID: 0000-0001-6591-6421

Corinne Collett (C)

From the Norfolk and Norwich University Hospitals NHS Foundation Trust (T.T.M.L., H.R.M.) and the Norwich Clinical Trials Unit (C.C., E.F., M.H., L.S.), Norwich Medical School (T.T.M.L., H.R.M.), University of East Anglia, Norwich, Cambridge University Hospitals NHS Foundation Trust (S.H.), and the Wellcome-MRC Institute of Metabolic Science, University of Cambridge (M.E.W., R.H.), Cambridge, the Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds (E.M.S.), the Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow (R.S.L.), King's College Hospital NHS Foundation Trust, London (K.F.H.), the Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast (D.R.M.), Barnard Health Research, Southampton (K.B.-K.), and the Usher Institute (D.R., J.L.) and the Centre for Cardiovascular Science (R.M.R.), University of Edinburgh, Edinburgh - all in the United Kingdom; and the Jaeb Center for Health Research, Tampa, FL (S.B., J.S., C.K., R.B.).

Simon Bergford (S)

From the Norfolk and Norwich University Hospitals NHS Foundation Trust (T.T.M.L., H.R.M.) and the Norwich Clinical Trials Unit (C.C., E.F., M.H., L.S.), Norwich Medical School (T.T.M.L., H.R.M.), University of East Anglia, Norwich, Cambridge University Hospitals NHS Foundation Trust (S.H.), and the Wellcome-MRC Institute of Metabolic Science, University of Cambridge (M.E.W., R.H.), Cambridge, the Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds (E.M.S.), the Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow (R.S.L.), King's College Hospital NHS Foundation Trust, London (K.F.H.), the Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast (D.R.M.), Barnard Health Research, Southampton (K.B.-K.), and the Usher Institute (D.R., J.L.) and the Centre for Cardiovascular Science (R.M.R.), University of Edinburgh, Edinburgh - all in the United Kingdom; and the Jaeb Center for Health Research, Tampa, FL (S.B., J.S., C.K., R.B.).

Sara Hartnell (S)

From the Norfolk and Norwich University Hospitals NHS Foundation Trust (T.T.M.L., H.R.M.) and the Norwich Clinical Trials Unit (C.C., E.F., M.H., L.S.), Norwich Medical School (T.T.M.L., H.R.M.), University of East Anglia, Norwich, Cambridge University Hospitals NHS Foundation Trust (S.H.), and the Wellcome-MRC Institute of Metabolic Science, University of Cambridge (M.E.W., R.H.), Cambridge, the Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds (E.M.S.), the Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow (R.S.L.), King's College Hospital NHS Foundation Trust, London (K.F.H.), the Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast (D.R.M.), Barnard Health Research, Southampton (K.B.-K.), and the Usher Institute (D.R., J.L.) and the Centre for Cardiovascular Science (R.M.R.), University of Edinburgh, Edinburgh - all in the United Kingdom; and the Jaeb Center for Health Research, Tampa, FL (S.B., J.S., C.K., R.B.).

Eleanor M Scott (EM)

From the Norfolk and Norwich University Hospitals NHS Foundation Trust (T.T.M.L., H.R.M.) and the Norwich Clinical Trials Unit (C.C., E.F., M.H., L.S.), Norwich Medical School (T.T.M.L., H.R.M.), University of East Anglia, Norwich, Cambridge University Hospitals NHS Foundation Trust (S.H.), and the Wellcome-MRC Institute of Metabolic Science, University of Cambridge (M.E.W., R.H.), Cambridge, the Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds (E.M.S.), the Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow (R.S.L.), King's College Hospital NHS Foundation Trust, London (K.F.H.), the Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast (D.R.M.), Barnard Health Research, Southampton (K.B.-K.), and the Usher Institute (D.R., J.L.) and the Centre for Cardiovascular Science (R.M.R.), University of Edinburgh, Edinburgh - all in the United Kingdom; and the Jaeb Center for Health Research, Tampa, FL (S.B., J.S., C.K., R.B.).
ORCID: 0000-0001-5395-8261

Robert S Lindsay (RS)

From the Norfolk and Norwich University Hospitals NHS Foundation Trust (T.T.M.L., H.R.M.) and the Norwich Clinical Trials Unit (C.C., E.F., M.H., L.S.), Norwich Medical School (T.T.M.L., H.R.M.), University of East Anglia, Norwich, Cambridge University Hospitals NHS Foundation Trust (S.H.), and the Wellcome-MRC Institute of Metabolic Science, University of Cambridge (M.E.W., R.H.), Cambridge, the Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds (E.M.S.), the Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow (R.S.L.), King's College Hospital NHS Foundation Trust, London (K.F.H.), the Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast (D.R.M.), Barnard Health Research, Southampton (K.B.-K.), and the Usher Institute (D.R., J.L.) and the Centre for Cardiovascular Science (R.M.R.), University of Edinburgh, Edinburgh - all in the United Kingdom; and the Jaeb Center for Health Research, Tampa, FL (S.B., J.S., C.K., R.B.).

Katharine F Hunt (KF)

From the Norfolk and Norwich University Hospitals NHS Foundation Trust (T.T.M.L., H.R.M.) and the Norwich Clinical Trials Unit (C.C., E.F., M.H., L.S.), Norwich Medical School (T.T.M.L., H.R.M.), University of East Anglia, Norwich, Cambridge University Hospitals NHS Foundation Trust (S.H.), and the Wellcome-MRC Institute of Metabolic Science, University of Cambridge (M.E.W., R.H.), Cambridge, the Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds (E.M.S.), the Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow (R.S.L.), King's College Hospital NHS Foundation Trust, London (K.F.H.), the Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast (D.R.M.), Barnard Health Research, Southampton (K.B.-K.), and the Usher Institute (D.R., J.L.) and the Centre for Cardiovascular Science (R.M.R.), University of Edinburgh, Edinburgh - all in the United Kingdom; and the Jaeb Center for Health Research, Tampa, FL (S.B., J.S., C.K., R.B.).

David R McCance (DR)

From the Norfolk and Norwich University Hospitals NHS Foundation Trust (T.T.M.L., H.R.M.) and the Norwich Clinical Trials Unit (C.C., E.F., M.H., L.S.), Norwich Medical School (T.T.M.L., H.R.M.), University of East Anglia, Norwich, Cambridge University Hospitals NHS Foundation Trust (S.H.), and the Wellcome-MRC Institute of Metabolic Science, University of Cambridge (M.E.W., R.H.), Cambridge, the Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds (E.M.S.), the Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow (R.S.L.), King's College Hospital NHS Foundation Trust, London (K.F.H.), the Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast (D.R.M.), Barnard Health Research, Southampton (K.B.-K.), and the Usher Institute (D.R., J.L.) and the Centre for Cardiovascular Science (R.M.R.), University of Edinburgh, Edinburgh - all in the United Kingdom; and the Jaeb Center for Health Research, Tampa, FL (S.B., J.S., C.K., R.B.).

Katharine Barnard-Kelly (K)

From the Norfolk and Norwich University Hospitals NHS Foundation Trust (T.T.M.L., H.R.M.) and the Norwich Clinical Trials Unit (C.C., E.F., M.H., L.S.), Norwich Medical School (T.T.M.L., H.R.M.), University of East Anglia, Norwich, Cambridge University Hospitals NHS Foundation Trust (S.H.), and the Wellcome-MRC Institute of Metabolic Science, University of Cambridge (M.E.W., R.H.), Cambridge, the Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds (E.M.S.), the Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow (R.S.L.), King's College Hospital NHS Foundation Trust, London (K.F.H.), the Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast (D.R.M.), Barnard Health Research, Southampton (K.B.-K.), and the Usher Institute (D.R., J.L.) and the Centre for Cardiovascular Science (R.M.R.), University of Edinburgh, Edinburgh - all in the United Kingdom; and the Jaeb Center for Health Research, Tampa, FL (S.B., J.S., C.K., R.B.).

David Rankin (D)

From the Norfolk and Norwich University Hospitals NHS Foundation Trust (T.T.M.L., H.R.M.) and the Norwich Clinical Trials Unit (C.C., E.F., M.H., L.S.), Norwich Medical School (T.T.M.L., H.R.M.), University of East Anglia, Norwich, Cambridge University Hospitals NHS Foundation Trust (S.H.), and the Wellcome-MRC Institute of Metabolic Science, University of Cambridge (M.E.W., R.H.), Cambridge, the Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds (E.M.S.), the Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow (R.S.L.), King's College Hospital NHS Foundation Trust, London (K.F.H.), the Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast (D.R.M.), Barnard Health Research, Southampton (K.B.-K.), and the Usher Institute (D.R., J.L.) and the Centre for Cardiovascular Science (R.M.R.), University of Edinburgh, Edinburgh - all in the United Kingdom; and the Jaeb Center for Health Research, Tampa, FL (S.B., J.S., C.K., R.B.).

Julia Lawton (J)

From the Norfolk and Norwich University Hospitals NHS Foundation Trust (T.T.M.L., H.R.M.) and the Norwich Clinical Trials Unit (C.C., E.F., M.H., L.S.), Norwich Medical School (T.T.M.L., H.R.M.), University of East Anglia, Norwich, Cambridge University Hospitals NHS Foundation Trust (S.H.), and the Wellcome-MRC Institute of Metabolic Science, University of Cambridge (M.E.W., R.H.), Cambridge, the Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds (E.M.S.), the Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow (R.S.L.), King's College Hospital NHS Foundation Trust, London (K.F.H.), the Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast (D.R.M.), Barnard Health Research, Southampton (K.B.-K.), and the Usher Institute (D.R., J.L.) and the Centre for Cardiovascular Science (R.M.R.), University of Edinburgh, Edinburgh - all in the United Kingdom; and the Jaeb Center for Health Research, Tampa, FL (S.B., J.S., C.K., R.B.).

Rebecca M Reynolds (RM)

From the Norfolk and Norwich University Hospitals NHS Foundation Trust (T.T.M.L., H.R.M.) and the Norwich Clinical Trials Unit (C.C., E.F., M.H., L.S.), Norwich Medical School (T.T.M.L., H.R.M.), University of East Anglia, Norwich, Cambridge University Hospitals NHS Foundation Trust (S.H.), and the Wellcome-MRC Institute of Metabolic Science, University of Cambridge (M.E.W., R.H.), Cambridge, the Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds (E.M.S.), the Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow (R.S.L.), King's College Hospital NHS Foundation Trust, London (K.F.H.), the Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast (D.R.M.), Barnard Health Research, Southampton (K.B.-K.), and the Usher Institute (D.R., J.L.) and the Centre for Cardiovascular Science (R.M.R.), University of Edinburgh, Edinburgh - all in the United Kingdom; and the Jaeb Center for Health Research, Tampa, FL (S.B., J.S., C.K., R.B.).

Emma Flanagan (E)

From the Norfolk and Norwich University Hospitals NHS Foundation Trust (T.T.M.L., H.R.M.) and the Norwich Clinical Trials Unit (C.C., E.F., M.H., L.S.), Norwich Medical School (T.T.M.L., H.R.M.), University of East Anglia, Norwich, Cambridge University Hospitals NHS Foundation Trust (S.H.), and the Wellcome-MRC Institute of Metabolic Science, University of Cambridge (M.E.W., R.H.), Cambridge, the Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds (E.M.S.), the Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow (R.S.L.), King's College Hospital NHS Foundation Trust, London (K.F.H.), the Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast (D.R.M.), Barnard Health Research, Southampton (K.B.-K.), and the Usher Institute (D.R., J.L.) and the Centre for Cardiovascular Science (R.M.R.), University of Edinburgh, Edinburgh - all in the United Kingdom; and the Jaeb Center for Health Research, Tampa, FL (S.B., J.S., C.K., R.B.).

Matthew Hammond (M)

From the Norfolk and Norwich University Hospitals NHS Foundation Trust (T.T.M.L., H.R.M.) and the Norwich Clinical Trials Unit (C.C., E.F., M.H., L.S.), Norwich Medical School (T.T.M.L., H.R.M.), University of East Anglia, Norwich, Cambridge University Hospitals NHS Foundation Trust (S.H.), and the Wellcome-MRC Institute of Metabolic Science, University of Cambridge (M.E.W., R.H.), Cambridge, the Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds (E.M.S.), the Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow (R.S.L.), King's College Hospital NHS Foundation Trust, London (K.F.H.), the Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast (D.R.M.), Barnard Health Research, Southampton (K.B.-K.), and the Usher Institute (D.R., J.L.) and the Centre for Cardiovascular Science (R.M.R.), University of Edinburgh, Edinburgh - all in the United Kingdom; and the Jaeb Center for Health Research, Tampa, FL (S.B., J.S., C.K., R.B.).
ORCID: 0000-0002-0739-3412

Lee Shepstone (L)

From the Norfolk and Norwich University Hospitals NHS Foundation Trust (T.T.M.L., H.R.M.) and the Norwich Clinical Trials Unit (C.C., E.F., M.H., L.S.), Norwich Medical School (T.T.M.L., H.R.M.), University of East Anglia, Norwich, Cambridge University Hospitals NHS Foundation Trust (S.H.), and the Wellcome-MRC Institute of Metabolic Science, University of Cambridge (M.E.W., R.H.), Cambridge, the Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds (E.M.S.), the Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow (R.S.L.), King's College Hospital NHS Foundation Trust, London (K.F.H.), the Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast (D.R.M.), Barnard Health Research, Southampton (K.B.-K.), and the Usher Institute (D.R., J.L.) and the Centre for Cardiovascular Science (R.M.R.), University of Edinburgh, Edinburgh - all in the United Kingdom; and the Jaeb Center for Health Research, Tampa, FL (S.B., J.S., C.K., R.B.).

Malgorzata E Wilinska (ME)

From the Norfolk and Norwich University Hospitals NHS Foundation Trust (T.T.M.L., H.R.M.) and the Norwich Clinical Trials Unit (C.C., E.F., M.H., L.S.), Norwich Medical School (T.T.M.L., H.R.M.), University of East Anglia, Norwich, Cambridge University Hospitals NHS Foundation Trust (S.H.), and the Wellcome-MRC Institute of Metabolic Science, University of Cambridge (M.E.W., R.H.), Cambridge, the Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds (E.M.S.), the Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow (R.S.L.), King's College Hospital NHS Foundation Trust, London (K.F.H.), the Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast (D.R.M.), Barnard Health Research, Southampton (K.B.-K.), and the Usher Institute (D.R., J.L.) and the Centre for Cardiovascular Science (R.M.R.), University of Edinburgh, Edinburgh - all in the United Kingdom; and the Jaeb Center for Health Research, Tampa, FL (S.B., J.S., C.K., R.B.).

Judy Sibayan (J)

From the Norfolk and Norwich University Hospitals NHS Foundation Trust (T.T.M.L., H.R.M.) and the Norwich Clinical Trials Unit (C.C., E.F., M.H., L.S.), Norwich Medical School (T.T.M.L., H.R.M.), University of East Anglia, Norwich, Cambridge University Hospitals NHS Foundation Trust (S.H.), and the Wellcome-MRC Institute of Metabolic Science, University of Cambridge (M.E.W., R.H.), Cambridge, the Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds (E.M.S.), the Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow (R.S.L.), King's College Hospital NHS Foundation Trust, London (K.F.H.), the Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast (D.R.M.), Barnard Health Research, Southampton (K.B.-K.), and the Usher Institute (D.R., J.L.) and the Centre for Cardiovascular Science (R.M.R.), University of Edinburgh, Edinburgh - all in the United Kingdom; and the Jaeb Center for Health Research, Tampa, FL (S.B., J.S., C.K., R.B.).

Craig Kollman (C)

From the Norfolk and Norwich University Hospitals NHS Foundation Trust (T.T.M.L., H.R.M.) and the Norwich Clinical Trials Unit (C.C., E.F., M.H., L.S.), Norwich Medical School (T.T.M.L., H.R.M.), University of East Anglia, Norwich, Cambridge University Hospitals NHS Foundation Trust (S.H.), and the Wellcome-MRC Institute of Metabolic Science, University of Cambridge (M.E.W., R.H.), Cambridge, the Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds (E.M.S.), the Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow (R.S.L.), King's College Hospital NHS Foundation Trust, London (K.F.H.), the Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast (D.R.M.), Barnard Health Research, Southampton (K.B.-K.), and the Usher Institute (D.R., J.L.) and the Centre for Cardiovascular Science (R.M.R.), University of Edinburgh, Edinburgh - all in the United Kingdom; and the Jaeb Center for Health Research, Tampa, FL (S.B., J.S., C.K., R.B.).

Roy Beck (R)

From the Norfolk and Norwich University Hospitals NHS Foundation Trust (T.T.M.L., H.R.M.) and the Norwich Clinical Trials Unit (C.C., E.F., M.H., L.S.), Norwich Medical School (T.T.M.L., H.R.M.), University of East Anglia, Norwich, Cambridge University Hospitals NHS Foundation Trust (S.H.), and the Wellcome-MRC Institute of Metabolic Science, University of Cambridge (M.E.W., R.H.), Cambridge, the Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds (E.M.S.), the Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow (R.S.L.), King's College Hospital NHS Foundation Trust, London (K.F.H.), the Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast (D.R.M.), Barnard Health Research, Southampton (K.B.-K.), and the Usher Institute (D.R., J.L.) and the Centre for Cardiovascular Science (R.M.R.), University of Edinburgh, Edinburgh - all in the United Kingdom; and the Jaeb Center for Health Research, Tampa, FL (S.B., J.S., C.K., R.B.).

Roman Hovorka (R)

From the Norfolk and Norwich University Hospitals NHS Foundation Trust (T.T.M.L., H.R.M.) and the Norwich Clinical Trials Unit (C.C., E.F., M.H., L.S.), Norwich Medical School (T.T.M.L., H.R.M.), University of East Anglia, Norwich, Cambridge University Hospitals NHS Foundation Trust (S.H.), and the Wellcome-MRC Institute of Metabolic Science, University of Cambridge (M.E.W., R.H.), Cambridge, the Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds (E.M.S.), the Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow (R.S.L.), King's College Hospital NHS Foundation Trust, London (K.F.H.), the Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast (D.R.M.), Barnard Health Research, Southampton (K.B.-K.), and the Usher Institute (D.R., J.L.) and the Centre for Cardiovascular Science (R.M.R.), University of Edinburgh, Edinburgh - all in the United Kingdom; and the Jaeb Center for Health Research, Tampa, FL (S.B., J.S., C.K., R.B.).
ORCID: 0000-0003-2901-461X

Helen R Murphy (HR)

From the Norfolk and Norwich University Hospitals NHS Foundation Trust (T.T.M.L., H.R.M.) and the Norwich Clinical Trials Unit (C.C., E.F., M.H., L.S.), Norwich Medical School (T.T.M.L., H.R.M.), University of East Anglia, Norwich, Cambridge University Hospitals NHS Foundation Trust (S.H.), and the Wellcome-MRC Institute of Metabolic Science, University of Cambridge (M.E.W., R.H.), Cambridge, the Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds (E.M.S.), the Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow (R.S.L.), King's College Hospital NHS Foundation Trust, London (K.F.H.), the Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast (D.R.M.), Barnard Health Research, Southampton (K.B.-K.), and the Usher Institute (D.R., J.L.) and the Centre for Cardiovascular Science (R.M.R.), University of Edinburgh, Edinburgh - all in the United Kingdom; and the Jaeb Center for Health Research, Tampa, FL (S.B., J.S., C.K., R.B.).

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Automated Insulin Delivery in Women with...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Automated Insulin Delivery in Women with...
questionsmedicales.fr › Phénomènes physiologiques des appareils urinaire et reproducteur › Phénomènes physiologiques de la reproduction › Reproduction › Grossesse › Automated Insulin Delivery in Women with...
questionsmedicales.fr › Glucides › Sucres › Oses › Hexose › Glucose › Glycémie › Automated Insulin Delivery in Women with...
questionsmedicales.fr › Techniques d'investigation › Techniques de laboratoire clinique › Tests de chimie clinique › Analyse chimique du sang › Autosurveillance glycémique › Automated Insulin Delivery in Women with...
questionsmedicales.fr › Maladies du système immunitaire › Maladies auto-immunes › Diabète de type 1 › Automated Insulin Delivery in Women with...
questionsmedicales.fr › Facteurs biologiques › Toxines biologiques › Produits terminaux de glycation avancée › Protéines glyquées › Protéine glycosylée sérique › Hémoglobine glycosylée › Automated Insulin Delivery in Women with...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Effets physiologiques des médicaments › Hypoglycémiants › Automated Insulin Delivery in Women with...
questionsmedicales.fr › Acides aminés, peptides et protéines › Peptides › Hormones peptidiques › Hormones pancréatiques › Insulines › Insuline › Automated Insulin Delivery in Women with...
questionsmedicales.fr › Équipement et fournitures › Équipement chirurgical › Organes artificiels › Pompes à perfusion › Pompes à insuline › Automated Insulin Delivery in Women with...
questionsmedicales.fr › Maladies urogénitales › Maladies de l'appareil urogénital féminin et complications de la grossesse › Complications de la grossesse › Grossesse chez les diabétiques › Automated Insulin Delivery in Women with...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Résultat thérapeutique › Automated Insulin Delivery in Women with...