In part 1 of this Exclusive Interview, Grenye O’Malley talks with Diabetes in Control Publisher Steve Freed during the AACE 2018 convention in Boston, MA about prenatal diabetes and the challenges faced by women with diabetes who are pregnant and using an insulin pump.
Grenye O’Malley, MD is an endocrinology fellow at Mount Sinai in New York.
Transcript of this video segment:
Freed: This is Steve Freed and we’re here at AACE 2018. We have a special guest with us who had a presentation and maybe we can start off with you telling us about yourself and the type of practice you are in.
O’Malley: Sure, so I am currently an endocrine fellow at Mount Sinai Hospital and I am going to stay on as faculty next year there where I’ll be doing a mix of clinical and research, focusing on artificial pancreas technology and diabetes in pregnancy.
Freed: You are also working on the artificial pancreas, is that correct?
Freed: I’ll probably ask you about that also. Let’s start off with you telling us a little bit about the study that you are presenting at AACE.
O’Malley: Sure, so I had a poster this morning and basically, we studied women with type 1 diabetes during pregnancy. We looked at how their insulin pump settings changed throughout pregnancy and we’re trying to get more information about the specific changes that happened during pregnancy – what times of day the really big changes happened – and we did this to get more information for, eventually, an artificial pancreas.
Freed: And why did you choose this population?
O’Malley: So, pregnant women are historically understudied and, specifically, in type 1 diabetes, there is a lot of expert opinion about their care but there is very little data. So, in the US, there is only one study looking at the details of insulin pump therapy in these patients and that was only with 9 patients. It is also a really important time for the patients themselves because hypoglycemia and hyperglycemia and likely, just variability, all are associated with poorer outcomes and so they not only have to improve their control to really strict goals, but they also have to do it while being pregnant. So, it’s a population that really needs more help from technology.
Freed: Using a pump and using a syringe vial, for a person who is pregnant, is it always recommended they use an insulin pump?
O’Malley: It hasn’t been very well established if it’s really that much improvement. Sensor use has definitely been shown to improve outcomes but the pump really helps specifically with what we were looking at which were the times of day. So, with a pump, you can get much better control of dawn phenomenon which can be exaggerated in women in pregnancy and so it has those benefits that with the injections, you just can’t do without having the risk of lows