Title of project

Improving Diabetes Pregnancy Outcomes using Diabetes Technology and Targeted Therapy approaches

Abstract

The overall purpose of this application is to set up a collaborative Diabetes Pregnancy Danish-UK research programme to improve the health outcomes of women and babies, living with and affected by type 1 and type 2 diabetes. Our plans build on long-standing collaborations (~20 years) between leading multi-disciplinary Danish and UK researchers from diabetes, endocrinology and obstetrics. We will examine the use of innovative diabetes technology and of targeted glucose-lowering therapies used before, during and after pregnancy. We propose three inter-connected projects, with meaningful and inclusive Danish Patient & Public Involvement. Firstly, we are preparing a high quality randomised controlled trial (RCT) of Automated Insulin Delivery (AID) before, during and after type 1 diabetes (T1DM) pregnancy in four Danish centres (Copenhagen, Aarhus, Odense, Aalborg). This study builds on and extends the findings from our UK trial of AID. Taken together, the results from these studies, will inform the future management of T1DM pregnancy in Denmark, and internationally. Secondly, we will perform a Danish cohort study to describe the use of diabetes technology and/or targeted (insulin and non-insulin) therapies before and during type 2 diabetes pregnancy. This builds on Danish and UK data demonstrating increasing pre-pregnancy use of non-insulin pharmacotherapies. We will identify which subgroups of women with type 2 diabetes may benefit from using Continuous Glucose Monitoring (CGM) insulin, and/or pre-pregnancy non-insulin therapies, and whether this differs between Danish and UK patients. Thirdly, we will establish a collaboration with Danish statisticians for comparison of diabetes pregnancy outcomes between RCTs and real-world data. These combined Danish-UK real-world studies, will facilitate faster answers to key research questions on diabetes technology and targeted therapies, tested in larger and far more diverse patient cohorts, than would ever be possible with RCTs alone.