The Use of Automated Insulin Delivery (AID) Systems in Pregnancy | Recording-The Use of Automated Insulin Delivery (AID) Systems in Pregnancy

Video Transcription

Video Summary

This webinar, hosted by the ADA Pregnancy and Reproductive Health and Diabetes Technology Interest Groups, focused on the use of automated insulin delivery (AID) systems during pregnancy, especially for people with type 1 diabetes. Dr. Gwendolyn Jack opened with logistics, including CE credit instructions, Q&A guidance, and an announcement for a follow-up webinar on CGMs in pregnancy.<br /><br />Drs. Carol Levy and Grainne O’Malley reviewed the current evidence for several AID systems, emphasizing that none are FDA-approved for pregnancy in the U.S. They explained pregnancy-specific glycemic goals, the challenges of changing insulin needs across gestation, and the need to balance tighter glucose control against hypoglycemia risk, patient burden, and quality of life.<br /><br />They discussed trial data for CAM APS, Medtronic 780G, Tandem Control-IQ, Omnipod, and Twiist, noting that results cannot be directly compared because studies differed in design and participant characteristics. In general, AID systems improved time in range, especially overnight, and reduced hypoglycemia compared with standard care. However, many unanswered questions remain about optimal settings, system-specific adjustments, and real-world effectiveness.<br /><br />The speakers also covered labor, delivery, and postpartum management, stressing that pump use in these periods must be individualized. They highlighted off-label considerations such as temporary basal changes, sleep mode, extended boluses, and adjunctive strategies like U200 insulin in some systems.<br /><br />Finally, they encouraged referrals to the ongoing T1D Pregnancy and Me registry study, which is collecting real-world data to better answer these questions and improve care for pregnant people using diabetes technology.

Keywords

automated insulin delivery

pregnancy

type 1 diabetes

continuous glucose monitoring

glycemic control

hypoglycemia

insulin pump

off-label use

postpartum management

real-world data