Abstract：
This review outlines some of the extraordinary recent advances in diabetes technology, which are transforming the management of type 1 diabetes before, during and after pregnancy. It highlights recent improvements associated with use of continuous glucose monitoring (CGM) but acknowledges that neither CGM nor insulin pump therapy are adequate for achieving the pregnancy glucose targets. Furthermore, even hybrid closed-loop (HCL) systems that are clinically effective outside of pregnancy may not confer additional benefits throughout pregnancy. To date, there is only one HCL system, the CamAPS FX, with a strong evidence base for use during pregnancy, suggesting that the pregnancy benefits are HCL system specific. This is in stark contrast to HCL system use outside of pregnancy, where benefits are HCL category specific. The CamAPS FX HCL system has a rapidly adaptive algorithm and lower glucose targets with benefits across all maternal glucose categories, meaning that it is applicable for all women with type 1 diabetes, before and during pregnancy. For women of reproductive years living with type 2 diabetes, the relative merits of using non-insulin pharmacotherapies vs diabetes technology (dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter 2 inhibitors) are unknown. Despite the urgent unmet need and potential benefits, studies of pharmacotherapy and technology use are extremely limited in pregnant women with type 2 diabetes.
摘要：
这篇综述概述了糖尿病技术的一些非凡的最新进展，以前正在改变1型糖尿病的管理，怀孕期间和之后。它强调了最近与使用连续葡萄糖监测（CGM）相关的改进，但承认CGM和胰岛素泵治疗都不足以实现妊娠葡萄糖目标。此外，即使是妊娠外临床有效的混合闭环(HCL)系统,也可能无法在整个妊娠期间带来额外的益处.迄今为止,只有一个HCL系统，CamAPSFX,在怀孕期间使用的强有力的证据基础，提示妊娠益处是HCL系统特异性的。这与怀孕外使用HCL系统形成鲜明对比，其中福利是HCL类别特定的。CamAPSFXHCL系统具有快速自适应算法和较低的葡萄糖目标，可在所有母体葡萄糖类别中受益，这意味着它适用于所有患有1型糖尿病的女性，怀孕前和怀孕期间。对于患有2型糖尿病的育龄妇女，使用非胰岛素药物疗法与糖尿病技术的相对优点(二肽基肽酶-4抑制剂，胰高血糖素样肽-1受体激动剂和钠-葡萄糖协同转运蛋白2抑制剂）是未知的。尽管有迫切的未满足的需求和潜在的好处，对2型糖尿病孕妇的药物治疗和技术使用的研究极为有限.
