{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T23:17:31Z","timestamp":1789773451097,"version":"4.0.1"},"reference-count":21,"publisher":"American Diabetes Association","issue":"12","license":[{"start":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T00:00:00Z","timestamp":1697068800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"name":"Calgary Health Trust"},{"name":"Medtronic","award":["In-kind support of study supplies"],"award-info":[{"award-number":["In-kind support of study supplies"]}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,12,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>This study aimed to evaluate the efficacy of closed-loop insulin delivery postpartum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>In this open-label, randomized controlled trial, postpartum individuals with type 1 diabetes were randomized to hybrid closed-loop insulin delivery with the MiniMed 670G\/770G system in automode or sensor-augmented pump therapy in the first 12-weeks postpartum followed by a continuation phase with closed-loop insulin delivery for all until 24 weeks postpartum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Eighteen participants (mean \u00b1 SD age 32 \u00b1 3.5 years, diabetes duration 22 \u00b1 7.3 years, and early pregnancy HbA1c 52 \u00b1 6.8 mmol\/mol [6.9 \u00b1 0.9%]) completed 24 weeks of postpartum follow-up. In the randomized phase, percent time in range 70\u2013180 mg\/dL (3.9\u201310 mmol\/L) did not differ between groups (79.2 \u00b1 8.7% vs. 78.2 \u00b1 6.0%; P = 0.41). Participants randomized to closed-loop insulin delivery spent less time &amp;lt;70 mg\/dL (3.9 mmol\/L) and &amp;lt;54 mg\/dL (3.0 mmol\/L) (1.7 \u00b1 0.8% vs. 5.5 \u00b1 3.3% [P &amp;lt; 0.001] and 0.3 \u00b1 0.2% vs. 1.1 \u00b1 0.9% [P = 0.008]). Time &amp;gt;180 mg\/dL (10 mmol\/L) was not different between groups (18.7 \u00b1 8.8% vs. 15.9 \u00b1 7.7%; P = 0.21). In the continuation phase, those initially randomized to sensor-augmented pump therapy had less time &amp;lt;70 mg\/dL after initiation of closed-loop insulin delivery (5.5 \u00b1 3.3% vs. 3.3 \u00b1 2.2%; P = 0.039). The closed-loop group maintained similar glycemic metrics in both study phases. There were no episodes of diabetic ketoacidosis or severe hypoglycemia in the randomized or continuation phase in either group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Women randomized to closed-loop insulin delivery postpartum had less hypoglycemia than those randomized to sensor-augmented pump therapy. There were no safety concerns. These findings are reassuring for use of closed-loop insulin delivery postpartum because of its potential to reduce hypoglycemia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc23-0882","type":"journal-article","created":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T15:22:43Z","timestamp":1697124163000},"page":"2258-2266","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":36,"title":["A Randomized Trial of Closed-Loop Insulin Delivery Postpartum in Type 1 Diabetes"],"prefix":"10.2337","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8911-8192","authenticated-orcid":false,"given":"Lois E.","family":"Donovan","sequence":"first","affiliation":[{"name":"1Departments of Medicine and Obstetrics and Gynecology, Cumming School of Medicine, University of Calgary and Alberta Children\u2019s Hospital Research Institute, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denice S.","family":"Feig","sequence":"additional","affiliation":[{"name":"2Department of Medicine, University of Toronto; Lunenfeld-Tanenbaum Research Institute; and Sinai Health System, Mount Sinai Hospital, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4448-9437","authenticated-orcid":false,"given":"Patricia","family":"Lemieux","sequence":"additional","affiliation":[{"name":"3Department of Medicine, University Laval, Quebec City, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6876-8727","authenticated-orcid":false,"given":"Helen R.","family":"Murphy","sequence":"additional","affiliation":[{"name":"4Norwich Medical School, University of East Anglia, Norwich, U.K"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rhonda C.","family":"Bell","sequence":"additional","affiliation":[{"name":"5Li Ka Shing Centre for Health Research Innovation, Division of Human Nutrition, Department of Agricultural, Food, and Nutritional Sciences, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8324-717X","authenticated-orcid":false,"given":"Ronald J.","family":"Sigal","sequence":"additional","affiliation":[{"name":"6Departments of Medicine, Cardiac Sciences, and Community Health Sciences, Cumming School of Medicine, Faculties of Medicine and Kinesiology, University of Calgary, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josephine","family":"Ho","sequence":"additional","affiliation":[{"name":"7Departments of Pediatrics and Endocrinology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi","family":"Virtanen","sequence":"additional","affiliation":[{"name":"7Departments of Pediatrics and Endocrinology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Crawford","sequence":"additional","affiliation":[{"name":"8Alberta Perinatal Health Program, Alberta Health Services, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3556-0820","authenticated-orcid":false,"given":"Jennifer M.","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"9Department of Internal Medicine, University of Manitoba and Children\u2019s Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2023,10,12]]},"reference":[{"key":"2023112719542126500_B1","doi-asserted-by":"crossref","first-page":"e15044","DOI":"10.1111\/dme.15044","article-title":"Existing standardised questionnaires do not adequately capture quality-of-life outcomes of greatest importance for those living with type 1 diabetes in pregnancy","volume":"40","author":"Gu","year":"2023","journal-title":"Diabet Med"},{"key":"2023112719542126500_B2","unstructured":"National Institute for Health and Care Excellence . 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