Automated Insulin Delivery in Pregnancy

Pregnancies with type 1 diabetes present significant risks for both the mother and the fetus, including increased mortality and morbidity. This includes higher rates of complications such as preeclampsia, preterm birth, and large infants. Hyperglycemia is a major risk factor in these pregnancies, emphasizing the importance of glucose control. Advances in medical management have improved glucose control during pregnancy. The CONCEPTT trial demonstrated that continuous glucose monitoring (CGM) improves maternal glucose control and reduces neonatal complications, compared to traditional monitoring. However, even with CGM, adverse outcomes remain common due to the complexity of the disease. Consequently, there is interest in using automated insulin delivery, technology that further improves maternal glucose levels. Automated insulin delivery, using CGM, pumps, and algorithms, aims for tighter glucose management. Most automated insulin delivery systems currently used are hybrid closed-loop systems, requiring some user input. Studies on automated insulin delivery may further decrease these risks for both mothers and fetuses.