Type 1 Diabetes in Pregnancy

Diabetes management has been revolutionized by automated insulin delivery (AID) systems, which are now the preferred method of insulin therapy for nonpregnant people with type 1 diabetes (T1D). This chapter provides detailed information regarding AID systems to assist clinicians in supporting the growing population of gravidas with T1D who elect for off-label use of AID systems in pregnancy. First, we review the details of the 5 AID systems that are currently available for use in the United States, including unique features of each system and how they vary with regards to delivery of basal, prandial, and correctional insulin. Second, we summarize the evidence from observational and interventional studies examining the use of these systems in the antepartum, intrapartum, and postpartum periods. Finally, we provide practical tips regarding use of AID systems in pregnancy, with a focus on assistive techniques that can support the unique demands of gestation.