902-P: Patient Experience and Clinical Outcomes in Pregnant Patients with Type 1 Diabetes Using Open-Source Automated Insulin Dosing Systems
Bibliographic record
Abstract
Type 1 diabetes (T1D) in pregnancy is associated with increased obstetrical and neonatal complications; thus, stringent glycemic targets are imperative. While commercial automated insulin dosing (AID) systems represent an important development in management of T1D, a limitation is that the glycemic targets are not adjustable for pregnancy. Before commercial AID, a community of people with T1D combined CGM sensors, insulin pumps and open-source code, developing open-source automated insulin delivery systems (OSAIDS). Given customizable glycemic targets, OSAIDS may fill an important clinical gap in pregnancy. We included participants ≥18 years old with T1D who had at least one pregnancy using OSAIDS. Of 37 completed surveys, motivations for using OSAIDS included commercial AID targets being too high for pregnancy (78%), increased ownership over diabetes (53%) and transparency (44%). The INsulin Dosing Systems: Perceptions, Ideas, Reflections and Expectations (INSPIRE) questionnaire showed that 100% strongly agreed or agreed with: helped in pregnancy (89% strongly agree), better quality of life (94% strongly agree) and better sleep (83% strongly agree). With a glycemic target of 3.5-7.8mmol/L (63-140mg/dl), 86% exceeded the time-in-range (TIR) target of ≥ 70% set by the Advanced Technologies & Treatments for Diabetes Congress. The majority (66%) had a more stringent TIR of ≥ 80%. The vast majority (97%) did not have severe hypoglycemia; 74% had time-below-range ≤ 4%. Of the 71% who experienced labor and delivery, 90% delivered at 37 weeks gestational age or greater; 90% did not have shoulder dystocia. Median birth weight was 3374g (SD 600g), 19% of newborns had macrosomia (>4000g). Neonatal hypoglycemia (<2.5mmol/L/<45mg/dl) occurred in 24% with 14% requiring NICU. OSAIDS provides excellent glycemic control, maternal quality of life and neonatal outcomes. More data is needed to validate these initial promising outcomes. Disclosure Y.Yang: None. I.Halperin: Advisory Panel; Sanofi, Speaker's Bureau; 3Boehringer Ingelheim Canada Ltd./Ltée, Abbott Diabetes, Dexcom, Inc., Novo Nordisk.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.013 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".