Tehnologija u liječenju šećerne bolesti tipa 1 u trudnoći

master's thesis

• Title (english): Technology in the treatment of type 1 diabetes during pregnancy
• Author: Karla Pavlović
• Mentor: Maja Baretić (mentor)
• Committee member: Vesna Elveđi-Gašparović (predsjednik povjerenstva)
• Committee member: Dinka Pavičić Baldani (član povjerenstva)
• Committee member: Maja Baretić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2024-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Šećerna bolest tip 1 autoimuna je bolest koju karakterizira inzulinopenija radi čega je neminovno liječenje inzulinom. Izazovna je za liječenje jer se doze inzulina mijenjaju tijekom dana ovisno razini glikemije, obroku, fizičkoj aktivnosti te općem stanju bolesti; radi svega navedenog potreban je stalni angažman bolesnika. Tijekom trudnoće, liječenje šećerne bolesti tip 1 još je izazovnije, jer je trudnoća dinamično stanje u kojemu se potrebe za inzulinom mijenjaju od trimestra do trimestra. Adekvatna regulacija bolesti izuzetno je važna zbog ishoda i za majku i za dijete. Značajan korak prema naprijed u regulaciji šećerne bolesti tip 1 je primjena moderne tehnologije. Moderna tehnologija u šećernoj bolesti tip 1 uključuje uređaje za kontinuirano mjerenje glikemije, inzulinske crpke te sustava zatvorene petlje koji koristi uređaj za kontinuirano mjerenje glikemije i inzulinsku pumpu koji su međusobno povezani upravljačkim algoritmom. Korištenje ovih tehnologija znatno je unaprijedilo praćenje i regulaciju glikemije osoba s tipom 1 šećene bolesti te olakšalo njihov svakodnevni život. U trudnica koje se liječe od tipa 1 dijabetesa, kod kojih je izrazito bitna striktna regulacija glikemije moderna tehnologija pomaže u ostvaruju ciljeva regulacije glikemije bez hipoglikemija. Pokazalo se da trudnice koje su koristile uređaje za kontinuirano mjerenje imaju bolju regulaciju glikemije te više vremena provedenog unutar ciljnih vrijednosti glikemije. Također, dokazane su i prednosti za sam plod u vidu smanjenja incidencije rađanja novorođenčadi velike za gestacijsku dob, rjeđih perioda hipoglikemije novorođenčadi te vremena provedenog u jedinicama intenzivne skrbi 24 h nakon poroda. Također, trudnice koje su koristile sustav zatvorene petlje provele su veći dio vremena unutar ciljnih vrijednosti glikemije, smanjile broj perioda noćne hipoglikemije te poboljšale vrijednosti parametra regulacije glikemije. Korištenje moderne tehnologije u trudnica s tipom 1 šćerne bolesti olakšava liječenje bolesti te poboljšava ishode trudnoće.

Abstract (english)

Type 1 diabetes is an autoimmune disease characterized by insulinopenia, making insulin treatment essential. It is challenging to manage because insulin doses vary throughout the day depending on blood glucose levels, meals, physical activity, and the overall state of the disease; therefore, constant patient engagement is required. During pregnancy, managing type 1 diabetes is even more challenging, as pregnancy is a dynamic state in which insulin needs to change from trimester to trimester. Proper disease regulation is important for the outcomes for both the mother and the child. A significant step forward in the management of type 1 diabetes is the application of modern technology. Modern technology in type 1 diabetes includes devices for continuous glucose monitoring, insulin pumps, and closed-loop systems that use a continuous glucose monitoring device and an insulin pump connected by a control algorithm. The use of these technologies has significantly improved the monitoring and regulation of blood glucose levels in people with type 1 diabetes and has made their daily lives easier. In pregnant women being treated for type 1 diabetes, where strict blood glucose regulation is crucial, modern technology helps achieve glucose regulation goals without hypoglycemia. It has been shown that pregnant women who use continuous glucose monitoring devices have better glucose regulation and more time spent within target glucose values. Additionally, benefits for the fetus have been demonstrated, including reduced incidence of large-for-gestational-age newborns, fewer periods of neonatal hypoglycemia, and less time spent in intensive care units 24 hours after birth. Pregnant women who used closed-loop systems also spent more time within target glucose values, reduced the number of nighttime hypoglycemic episodes, and improved glucose regulation parameters. The use of modern technology in pregnant women with type 1 diabetes facilitates disease management and improves pregnancy outcomes.

• Keywords: tip 1 šećerne bolesti; trudnoća; kontinuirano mjerenje glikemije; inzulinska pumpa; sustav zatvorene petlje
• Keywords (english): type 1 diabetes; pregnancy; continuous glucose monitoring; closed-loop system
• Language: croatian
• URN:NBN: urn:nbn:hr:105:772809
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-07-06 17:12:06