Introduction: Effective glucose management during labour and delivery is crucial for the health of both mother and baby. Traditional insulin delivery methods, which rely on manually adjusted basal rates, often fail to address the rapid and fluctuating insulin needs that arise during this critical time. Recent advancements in insulin pump technology, particularly those incorporating real-time continuous glucose monitoring (CGM), offer a more adaptive and responsive approach to insulin regulation.
Methods: This presentation will examine the functionalities and settings of three advanced hybrid closed-loop insulin delivery systems— MiniMed™ 780G system, Mylife™ YpsoPump using CamAPS® FX App, and Tandem t:slim X2™ Insulin Pump with Control-IQ ™ technology. Clinical examples will illustrate their application during labour and delivery. The focus will be on how these technologies impact glucose management, highlighting their benefits and challenges in a practical context.
Results: Hybrid closed-loop systems have demonstrated superior performance in maintaining stable glucose levels compared to conventional methods. By continuously adjusting insulin delivery based on real-time glucose values, these systems effectively reduce the risks of hyperglycaemia and hypoglycaemia, conditions that can be exacerbated during labour. Clinical examples will showcase each pump’s capabilities in mitigating these risks.
Discussion: Despite their advantages, hybrid closed-loop systems require careful planning and coordination with the healthcare team. Technical issues, variations in insulin needs, and the physical stress of labour can impact glucose control. Effective management involves comprehensive pre-delivery planning, ongoing patient assessment, and a robust backup strategy.
Conclusion: Insulin pumps with hybrid closed-loop systems offer substantial improvements in managing blood glucose levels during delivery. Understanding the functionalities and settings of different pumps is crucial for optimising glycaemic control. However, their effective use requires continuous monitoring and a well-prepared contingency plan to handle any potential complications.