title: Using technology to advance type 1 diabetes care among women during the reproductive years and in pregnancy.
abstract: The prevalence of diabetes is increasing globally. Technology to improve care among individuals with diabetes is constantly being developed. Women living with Type 1 Diabetes Mellitus (T1DM) have unique challenges affecting their glucose control relating to menstrual cycles, pregnancy, and menopause. The purpose of this review is to examine the literature related to the use of technology to help women with T1DM manage their diabetes during the reproductive years, pregnancy, and beyond. Continuous subcutaneous insulin infusion (CSII) therapy can provider equivalent or better glucose control when compared with multiple daily injections (MDI), with less hypoglycemia, diabetic ketoacidosis, and weight gain. The CSII therapy has features that could help improve glucose control over the menstrual cycle, menopause, and pregnancy, although the most studied of these stages is pregnancy. Continuous glucose monitoring (CGM) can be combined with any insulin delivery system (MDI or CSII) to provide data on glucose values every few minutes and show glucose trends over time. CGM introduction can highlight glucose variability for women with T1DM, may be beneficial during pregnancy, and can reduce hypoglycemia. Sensor-augmented pump therapy and hybrid artificial pancreas (closed-loop) systems are promising tools that improve outcomes among individuals with diabetes. The use of modern technology to improve glucose and metabolic control among menopausal women with diabetes has not been well studied. Internet and phone-based technologies are emerging as important tools that may help with diabetes self-care for women living with diabetes.
authors.affiliation: a Barbara Davis Center for Diabetes , Aurora , CO , USA.
authors.forename: Sarit
authors.initials: S
authors.lastname: Polsky
authors.affiliation: a Barbara Davis Center for Diabetes , Aurora , CO , USA.
authors.forename: Dominique
authors.initials: D
authors.lastname: Giordano
authors.affiliation: a Barbara Davis Center for Diabetes , Aurora , CO , USA.
authors.forename: Mary K
authors.initials: MK
authors.lastname: Voelmle
authors.affiliation: a Barbara Davis Center for Diabetes , Aurora , CO , USA.
authors.forename: Rachel
authors.initials: R
authors.lastname: Garcetti
authors.affiliation: a Barbara Davis Center for Diabetes , Aurora , CO , USA.
authors.forename: Satish K
authors.initials: SK
authors.lastname: Garg
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D055104:Infusions, Subcutaneous / Q000379:methods; D007328:Insulin / Q000008:administration & dosage*; D007332:Insulin Infusion Systems; D020407:Internet; D008593:Menopause / Q000378:metabolism; D008991:Monitoring, Physiologic / Q000295:instrumentation / Q000379:methods; D019397:Pancreas, Artificial; D011181:Postnatal Care; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000188:drug therapy*; D011295:Prenatal Care; D017216:Telemedicine
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Type 1 diabetes mellitus; artificial pancreas; continuous glucose monitor; insulin pump; menopause; pregnancy; technology; telemedicine; women