‘Artificial pancreas’ to be given to women with diabetes to cut pregnancy risks

Pregnant women with type 1 diabetes in England are to be given a special artificial pancreas to reduce the risk of stillbirth and miscarriage.

Mothers-to-be with the condition have higher risks as pregnancy hormones can make it harder for them to regulate their blood glucose levels.

They will now be offered a “game-changing” specialised tool to help them manage their blood glucose levels effectively.

About 400,000 people in the UK have type 1 diabetes, a lifelong condition which causes the immune system to attack insulin-producing cells in the pancreas.

Insulin helps the body use sugar for energy, and without this hormone, blood sugar levels can become dangerously high.

Type 1 diabetes needs constant management to keep blood sugar within range, with patients required to take insulin through injections or pumps.

If diabetes is poorly controlled during pregnancy it can lead to stillbirth, miscarriage, larger babies, birth injuries and increased need for neonatal care.

The new tool, also known as a hybrid closed loop system, will be offered to the 2,000 women with type 1 diabetes who fall pregnant each year.

It will be also offered to women who have type 1 diabetes and are planning a pregnancy, NHS England said.

The technology, which is linked to a mobile phone app, delivers the precise insulin dosages a woman requires before and during pregnancy.

Unlike other artificial pancreases, this allows pregnant women to set a glucose target to the lower level required to achieve better outcomes in pregnancy, NHS England said.

It also allows remote monitoring by health workers which means fewer check-ups for mothers-to-be.

The tool has already been given to a number of women, including mother-of-two Nina Willer.

The 40-year-old, from Norwich, works as a diabetes specialist midwife at Norfolk and Norwich University Hospital.

During her first pregnancy, Ms Willer monitored her condition using finger prick glucose tests and an insulin pump every hour during the day and every 30 minutes overnight.

When her baby girl was born she needed neonatal intensive care for a week and received treatment for jaundice, weight issues and other health complications.

During her second pregnancy, Ms Willer used the specialist artificial pancreas and did not need to perform the same constant monitoring.

Her second daughter was born healthy at 36 weeks.

“This new generation ‘artificial pancreas’ is a game-changer for women with type 1 diabetes who are pregnant or planning a pregnancy, so it is fantastic that its available on NHS to protect the health of mums-to-be and babies,” Ms Willer said.

“As someone who has used this tech when I was pregnant with my own daughter, and as an NHS diabetes specialist midwife to help my patients, I’ve both experienced and seen how this technology can quickly and simply help women with type 1 diabetes achieving much better glucose levels, and ease the physical and mental burden of this condition.

“I am so proud of what the NHS is doing with the help of this technology, and am acutely aware of the onward effect that this will have, not only for patients but their family, their livelihood and of course their long-term health, once a pregnancy is complete.”

Kate Brintworth, chief midwifery officer for England, said: “This life-changing technology is great news for women with type 1 diabetes because their chronic condition can make it difficult for them to effectively regulate their blood glucose levels to have a safe pregnancy.

“Effective management of blood glucose levels before and during pregnancy for women living with type 1 diabetes has been shown to reduce the risk of poor maternity outcomes, such as miscarriage, stillbirth birth and birth injuries, and minimise risk to a baby’s development.

“The NHS is offering this cutting-edge ‘artificial pancreas’ because we want to transform the experiences of women with type 1 diabetes – helping to make this special time in their life safer, less stressful, and more enjoyable.”

Partha Kar, type 1 diabetes technology lead at NHS England, added: “This ingenious yet simple technology is helping pregnant women living with type 1 diabetes – and those planning a pregnancy – live better lives, improving maternal outcomes for them, reducing serious health complications, and making care simpler.”

Anthony Walker, senior policy officer at Diabetes UK, said: “Offering the hybrid closed loop systems that are proven to be most effective during pregnancy – and the additional devices like mobile phones needed to use them – is essential in ensuring that everyone has access to the right technology for them.”