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Optimizing Automated Insulin Delivery Systems for Pregnancy.

Emily D Szmuilowicz1, Denice S Feig2

  • 1Division of Endocrinology, Metabolism and Molecular Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.

Diabetes Spectrum : a Publication of the American Diabetes Association
|November 19, 2025
PubMed
Summary
This summary is machine-generated.

Automated insulin delivery (AID) systems are not FDA-approved for pregnancy, posing challenges for pregnant individuals with diabetes. This article offers workarounds for off-label AID use and continuous glucose monitoring (CGM) interpretation during pregnancy.

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Area of Science:

  • Endocrinology
  • Medical Technology
  • Maternal-Fetal Medicine

Background:

  • Automated insulin delivery (AID) systems have transformed diabetes management but lack FDA approval for use during pregnancy.
  • Current AID systems do not meet the stringent glucose targets recommended for pregnant individuals.
  • Existing algorithms are not optimized for the unique glycemic fluctuations and increasing insulin resistance of pregnancy.

Purpose of the Study:

  • To address the challenges of using AID systems off-label during pregnancy.
  • To provide guidance on interpreting continuous glucose monitoring (CGM) data in pregnant individuals using AID.
  • To suggest best-practice workarounds for optimizing diabetes care in pregnancy with AID.

Main Methods:

  • Review of current limitations of AID systems in pregnancy.
  • Analysis of challenges in CGM interpretation during gestation.
  • Development of practical strategies for managing AID therapy in pregnant individuals.

Main Results:

  • Identification of key obstacles in AID use and CGM interpretation during pregnancy.
  • Proposal of specific workarounds to mitigate these challenges.
  • Emphasis on individualized care based on clinical factors and patient preferences.

Conclusions:

  • Despite limitations, off-label AID use is common in pregnancy.
  • Careful management and interpretation of CGM data are crucial for pregnant individuals using AID.
  • Best-practice workarounds can help optimize glycemic control and improve outcomes for pregnant individuals with diabetes using AID.