Athina Stamati1 · Athanasios Christoforidis2
Received: 7 October 2024 / Accepted: 31 December 2024 / Published online: 10 January 2025 © The Author(s) 2025
Abstract
Aims To assess the efficacy and safety of automated insulin delivery (AID) systems compared to standard care in managing glycaemic control during pregnancy in women with Type 1 Diabetes Mellitus (T1DM).
Methods We searched MEDLINE, Cochrane Library, registries and conference abstracts up to June 2024 for randomized controlled trials (RCTs) and observational studies comparing AID to standard care in pregnant women with T1DM. We con-ducted random effects meta-analyses for % of 24-h time in range of 63–140 mg/dL (TIR), time in hyperglycaemia (>140 mg/ dl and>180 mg/dL), hypoglycaemia (<63 mg/dl and<54 mg/dL), total insulin dose (units/kg/day), glycemic variability (%), changes in HbA1c (%), maternal and fetal outcomes.
Results Thirteen studies (450 participants) were included. AID significantly increased TIR (Mean difference, MD 7.01%, 95% CI 3.72–10.30) and reduced time in hyperglycaemia>140 mg/dL and>180 mg/dL (MD – 5.09%, 95% CI – 9.41 to – 0.78 and MD – 2.44%, 95% CI – 4.69 to – 0.20, respectively). Additionally, glycaemic variability was significantly reduced (MD – 1.66%, 95% CI – 2.73 to – 0.58). Other outcomes did not differ significantly.
Conclusion AID systems effectively improve glycaemic control during pregnancy in women with T1DM by increasing TIR and reducing hyperglycaemia without any observed adverse short-term effects on maternal and fetal outcomes.
Keywords Automated insulin delivery · Pregnancy · Type 1 diabetes mellitus · Systematic review · Meta-analysis
Nikoline Nygaard1 · Anne Kirstine Eriksen2 · Lars Ängquist3 · Daniel Belstrøm1 · Evelina Stankevic3 · Torben Hansen3 · Anja Olsen2 · Merete Markvart1
Received: 15 August 2024 / Accepted: 22 December 2024 / Published online: 13 January 2025 © The Author(s) 2025
Background Evidence suggests a bidirectional relationship between oral health status and type 2 diabetes (T2D) in adults. Studies on associations between childhood oral health and T2D in adulthood are lacking.
Methods This is a nationwide Danish registry-based cohort study of individuals born between 1963 and 1972, having at least one registration in the National Child Odontology Registry between 1972 and 1987 (n=627,758). Follow-up lasted from 1995 to 2018. Main exposure variables were the highest achieved levels of dental caries and gingivitis between 1972 and 1987. The outcome was T2D diagnosis during follow-up. Data was analyzed using Cox-regression, stratified on sex, with age as the underlying timescale and highest achieved level of education between age 25–30 years as Cox-strata. Main analyses were conducted with and without age-restrictions (T2D diagnosis before/after age 40).
Results Compared to lowest-level references, high levels of gingivitis associated with increased hazard ratios (HRs) of T2D in both males (HR [95% confidence interval]: 1.59 [1.47; 1.72]) and females (1.87 [1.68; 2.08]), as did severe dental caries (males: (1.15 [1.04; 1.27], in females: 1.19 [1.06; 1.35]). Below age 40, gingivitis associated with increased HRs in males (1.84 ([1.58; 2.15]) and females (1.94 [1.63; 2.30]). Above age 40, both exposures displayed higher HRs in males (high gin-givitis: 1.52 [1.39; 1.66] vs. severe caries: 1.23 [1.09; 1.38]) and females (1.83 [1.59; 2.10] vs. 1.37 [1.17; 1.59]).
Conclusions Data suggest an association between childhood dental caries and gingivitis with risk of receiving a T2D diag-nosis in adulthood. However, results are affected by residual confounding warranting further studies.
Keywords Cohort studies · Dental caries · Diabetes mellitus · Type 2 · Gingivitis
伤口世界平台生态圈，以“关爱人间所有伤口患者”为愿景，连接、整合和拓展线上和线下的管理慢性伤口的资源，倡导远程、就近和居家管理慢性伤口，解决伤口专家的碎片化时间的价值创造、诊疗经验的裂变复制、和患者的就近、居家和低成本管理慢性伤口的问题。
2019广东省医疗行业协会伤口管理分会年会
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