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Mary Loeken Part 7, Improvements In The Prevention of Diabetes Birth Defects

In part 7 of this Exclusive Interview, Dr. Mary Loeken talks with Diabetes in Control Publisher Steve Freed during the ADA meeting in San Diego, CA about prevention of diabetes birth defects and the advances in research to decrease the risk of birth defects in pregnant women with diabetes.

Mary Loeken, PhD is an Associate Professor of Medicine at Harvard Medical School and an Investigator at Joslin Diabetes Center.

Transcript of this video segment:

Steve:  Technology has changed just about every aspect of what we do. When you leave here next year, an uber pulls up and there’s no driver and there’s a voice that says, “Step in. I’ll be your driver. You can’t see me, but I’m here.” I always ask people would you get in that car? [laughter] So things have changed dramatically, and what we have done over the last 25 years, we’ve actually duplicated and now we are doing it every 5 years. From your expertise, have defects from pregnancy caused by diabetes improved over the last years or are we still at the same place?

Dr. Loeken: I think we have a much better understanding, and we have data to support why women should be in good glycemic control. It used to be you’ll have a better outcome of pregnancy and now we know specific steps that occur in the embryo that will be normalized if you improve glycemic control. Technology, as I alluded to before, may allow us to use strategies to come more closely to giving glucose in the fetal circulation to what occurs in a non-diabetic pregnancy.  That is not my work, but there might be artificial intelligence that is involved in continuous glucose monitoring and insulin pump that is a generation better than what we have now and is also user-friendly.

Steve: Would you say that CGM has made a major impact in preventing defects?

Dr. Loeken: I don’t think that there is good research in that. I do know of a few colleagues who have done some monitoring of that. For ethical reasons, you want to have women in good glycemic control.  If you have women entering the study you want to get the birth defects down to as low as possible for ethical reasons.  You need to have a large enough sample size so you can see a statistical difference when, for example, you have used a continuous glucose monitor over other non-continuous glucose monitoring approaches.  I don’t think we have the hard data yet.

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