SUN-157 Finding The Sweet Spot: Successful Use of Tslim Control IQ During Pregnancy

Abstract B. Zaidan: None. R. Malek: None. Background: Successful management of type 1 diabetes mellitus (T1DM) in pregnancy poses challenges to women and their providers due to tight glycemic goals (63-140mg/dL) requiring intensive glucose monitoring and insulin adjustment. Studies have shown that only 10% of pregnant women achieve more than 70% time in range (1). A multicenter randomized clinical trial used hybrid closed loop therapy in women with preexisting T1DM in pregnancy significantly improved maternal glycemic control during pregnancy (2). A case series of 4 pregnant women with T1DM using Tslim with Control-IQ showed time in range glucose 73.4% to 78.7%,78% to 83.6%, and 46.5% to 71.9% between the first and third trimesters, respectively (3). Case description: A 30-year-old patient with T1DM previously using Tslim with Control-IQ identified pregnancy at 6 weeks gestation. The patient was aware that the use of Control-IQ technology is not FDA approved for use in pregnancy and chose to remain on it. The patient’s blood sugars were evaluated every 2-4 weeks depending on stability with frequent setting adjustments. Data evaluated include time in range (TIR), time below range (TBR), and time above range (TAR) and neonatal outcomes. Result: The patient had a full-term pregnancy, delivering at 39 weeks. The pregnancy TIR (65-140mg/dl) in the 1st trimester was 68% with average blood glucose 125mg/dl; TIR in the 2nd trimester was 71% with average blood glucose of 129mg/dl; TIR in the 3rd trimester was 73% with average blood glucose of 119mg/dl. The TAR in the 1st trimester was less than 27%; in the 2nd trimester and 3rd trimester were less than 25%. The TBR in the 1st trimester was less than 3%; in the 2nd trimester was less than 4%; in the 3rd trimester was less than 3%. No episodes of diabetic ketoacidosis, severe hypoglycemia, emergency department visits or hospitalization occurred. The patient delivered a baby girl by C-section with no neonatal complications. The patient did develop post-partum hypertension that resolved. Conclusion: Pregnant women with T1DM need optimal blood glucose control for a healthy maternal and fetal outcome. Consistent with previously described case series (3), the off-label use of Tslim with Control-IQ technology in pregnancy reduced diabetes management burden and improved glycemic control. Reference: 1. Murphy HR. Continuous glucose monitoring targets in type 1 diabetes pregnancy: every 5% time in range matters. Vol. 62, Diabetologia. 2019 2.Lee TTM, Collett C, Bergford S, Hartnell S, Scott EM, Lindsay RS, et al. Automated Insulin Delivery in Women with Pregnancy Complicated by Type 1 Diabetes. N Engl J Med. 2023 3.Wang XS, Dunlop AD, McKeen JA, Feig DS, Donovan LE. Real-world use of Control-IQTM technology automated insulin delivery in pregnancy: A case series with qualitative interviews. Diabetic Medicine. 2023 Jun 1;40(6) Sunday, June 2, 2024