Pregnancy outcomes with the pregestational use of Minimed 780G compared to Minimed 640G: findings from a multicenter cohort study.

Abstract

Aim: To compare glycemic control and maternal-fetal outcomes of women with type 1 diabetes (T1D) using Minimed™ 780G (MM780G) with those women using Minimed™ 640G (MM640G) since before pregnancy.

Methods: Multicenter prospective cohort study of pregnant women with T1D in Spain. We evaluated HbA1c, time spent within (TIRp), below (TBRp) and above (TARp) the pregnancy-specific glucose range 3.5-7.8 mmol/L (63-140 mg/dL) and glucose variability (CV).

Results: Sixty-nine women were included (MM780G n = 40). At baseline, MM640G users had higher rates of severe hypoglycemia before pregnancy, without other between-group differences. The MM780G group had higher TIRp and lower TARp, TBRp and CV, but similar HbA1c in the first trimester of gestation. TBRp and CV remained significantly higher in the MM640G group throughout pregnancy. Higher HbA1c was observed in the MM780G group compared to the MM640G (6.28 ± 0.53% [45.1 ± 5.8 mmol/mol] vs. 5.97 ± 0.62 [41.8 ± 6.8], p = 0.003) in the second trimester. There were no differences in the mean change in HbA1c from the first to the third trimester of gestation between groups. MM780G users were more likely to have large-for-gestational-age infants (OR_adjusted 4.85, 95% CI 1.46-16.13, p = 0.010), macrosomia (OR_adjusted 12.17, 95% CI 1.49-99.72, p = 0.020) and cesarean section (OR_adjusted 4.19, 95% CI 1.34-13.11, p = 0.014) than the MM640G group.

Conclusions: Pregestational use of MM780G led to an initial improvement in TIRp, but this was not sustained in the second and third trimesters, with a 4-fold increased risk of delivering a LGA infant and undergoing cesarean section compared to MM640G users.