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Type 1 Diabetes in Pregnancy: Practical Tips for Managing Automated Insulin Delivery Systems
Nasim C Sobhani1, Kelly Engle2, Emily A Rosenberg2
1Division of Maternal Fetal Medicine, Department of Obstetrics Gynecology and Reproductive Sciences, University of California, San Francisco, CA.
Clinical Obstetrics and Gynecology
|April 13, 2026
Summary
Automated insulin delivery (AID) systems offer advanced diabetes management for type 1 diabetes (T1D). This guide details AID system use in pregnancy, aiding clinicians in supporting gravidas with T1D.
Area of Science:
- Endocrinology
- Medical Devices
- Reproductive Health
Background:
- Automated insulin delivery (AID) systems are the preferred therapy for nonpregnant individuals with type 1 diabetes (T1D).
- A growing population of pregnant individuals with T1D are using AID systems off-label.
- Clinicians require guidance on AID system use during pregnancy.
Purpose of the Study:
- To provide comprehensive information on AID systems for clinicians managing pregnant individuals with T1D.
- To review available AID systems and their application in pregnancy.
- To offer practical strategies for AID system use throughout gestation.
Main Methods:
- Review of 5 available AID systems in the U.S., detailing basal, prandial, and correctional insulin delivery.
- Summary of evidence from observational and interventional studies on AID use in antepartum, intrapartum, and postpartum periods.
- Inclusion of practical tips and assistive techniques for AID system use during pregnancy.
Main Results:
- Detailed comparison of 5 AID systems, highlighting unique features and insulin delivery variations.
- Synthesis of current evidence on the safety and efficacy of AID systems in pregnancy.
- Identification of specific challenges and supportive strategies for AID use in gestation.
Conclusions:
- AID systems represent a significant advancement in diabetes management for pregnant individuals with T1D.
- Evidence supports the use of AID systems during pregnancy, though off-label.
- Clinicians can effectively support pregnant individuals with T1D using AID systems with tailored guidance.
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