Automated Insulin Delivery Systems Improve Glycemic Control in Pregnant Women with Type 1 Diabetes

Strategic Insights -

Investigators at the University of Texas Southwestern Medical Center have published a study comparing glycemic control achieved during pregnancy by people with type 1 diabetes using automated insulin delivery (AID) systems versus standard of care therapy. The research found that AID systems improved time in range (TIR) and reduced time below range (TBR) and glucose standard deviation compared to standard care.

Key Takeaways:

  • Automated insulin delivery systems significantly improved glycemic control in pregnant women with type 1 diabetes, with a mean antenatal TIR of 68.5 ± 12.9 % compared to 55.7 ± 16.7 % (adjusted mean difference 7.9 %, 95 % CI: 0.8 to 15.0, p = 0.03).
  • The AID group achieved a lower TBR (1.7 ± 1.3 % vs 3.0 ± 2.8 %, p = 0.03), and lower glucose standard deviation (37.2 ± 8.0 vs 45.5 ± 8.9, p = 0.02) than standard of care.
  • This real-world study demonstrates the potential benefits of off-label AID use during pregnancy, which is not approved for pregnancy in the United States.
  • Standardized approaches to optimizing current AID systems are needed, particularly in pregnant women with type 1 diabetes.

Statistics:

  • 38 people with type 1 diabetes were included in the study: 21 treated with AIDs and 17 with standard of care.
  • The mean age of participants was not provided.
  • The study used a continuous glucose monitor (CGM) to track glucose levels.
  • Time in range (TIR) was defined as a glucose value within 3.9--7.8 mmol/L.
  • Time below range (TBR) was defined as a glucose value below 3.9 mmol/L.
  • Glucose standard deviation was calculated using the CGM data.

Sources:

  • "Use of commercially available automated insulin delivery systems in pregnant people with type 1 diabetes." Diabetes Research and Clinical Practice, 2025:112454.
  • University of Texas Southwestern Medical Center
  • Angela Q. Pham, Dept. of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390, United States.
  • Elsevier Ireland Ltd, Elsevier House, Brookvale Plaza, East Park Shannon, Co, Clare, 00000, Ireland.