SUN-520 Hybrid closed-loop insulin therapy in Women with Pregnancy complicated by Type 1 Diabetes: a Single center experience

Abstract Disclosure: B.S. bohlega: None. S. Inam: None. L.S. AlRasheed: None. H. Al-kubedan: None. A. Mai: None. I. Alghofaili: None. A. Aljohani: None. A. Robert: None. A. Alanazi: None. Background: Maternal antenatal hyperglycemia is a risk factor for both maternal and fetal complications. The use of continuous glucose monitoring in pregnancy is associated with improved glucose control and neonatal outcomes. However optimal glucose control remains difficult. In a recent randomized control trial, Automated Insulin Delivery using a hybrid closed- loop insulin pump (HCLP) in pregnant women with type 1 diabetes resulted in a 10.5 percentage increase in time that glucose levels were within the pregnancy-specific target range (TIR) with low risk of hypoglycemia. Methods: We collected the data of 13 pregnancies that were complicated by type 1 diabetes who were started on HCLP in pregnancy. Collected parameters included demographic data, blood sugar control before and after starting therapy, all reported maternal and fetal complications and therapy safety outcomes. Results: The mean age of women was 26.6 ± 4.82 years with an average of 15.2 ± 4.9 years of diabetes and a mean HBA1C of 8.36 ± 0.64 prior to pregnancy. Mean gestational age at staring pump was 16.69 Weeks . 30.7 % of women had known complications prior to pregnancy namely retinopathy and nephropathy. Indications for HCLP were severe recurrent hypoglycemia, hypoglycemia unawareness, high risk pregnancy and poor control. Prior to starting HCLP TIR was 47.5% this increased to up to 80.3% after starting therapy. Time spent below and above pregnancy-specific target range reduced from 7.9% and 37.6% to 3% and 20% respectively. Diabetes related pregnancy complications occurred in 4 out of 13 patients, emergency CS was needed in 8 women. Neonatal complications occurred in 8 out of 13 patients. One patient developed diabetic ketoacidosis after starting HCLP. Conclusions: The use of HCLP in pregnancies complicated with type 1 diabetes improved glycemic control with an improvement in time that glucose levels were within the pregnancy-specific target range by 32.8 % with reduced risk of hypoglycemia. Better outcomes are expected with earlier use and pregnancy specific HLCPs Presentation: Sunday, July 13, 2025