Hybrid Closed Loop Insulin Delivery in Pregnant Women with Type 1 Diabetes: A Feasibility Study Embedded in Routine Clinical Care

Pregnancy can be a challenging time for women with Type 1 Diabetes (T1D), as they face higher risks of complications. Maintaining optimal glucose control is essential, but is difficult during pregnancy due to physiological changes. This project aims to explore the potential of an innovative technology called the hybrid closed-loop (HCL) insulin delivery system, also known as the artificial pancreas. HCL systems combine continuous glucose monitoring (CGM) with automated insulin delivery, adapting insulin doses based on real-time glucose readings. In non-pregnant individuals with T1D, this technology has shown promise in improving glucose control and quality of life. However, HCL systems are not yet approved for use during pregnancy in most countries, including Australia, and there is limited knowledge about their effectiveness and safety in this context. Limited studies indicate increased time within the recommended glucose range for pregnancy and fewer hypoglycaemic events with HCL systems, although glucose targets are slightly higher than the recommended fasting levels in pregnancy. This project aims to assess the acceptability and feasibility of supervised HCL system use in pregnant women with T1D. It will compare the effectiveness of HCL systems with sensor-augmented pump therapy or multiple daily insulin injections. Additionally, it will evaluate patient satisfaction and diabetes-related stress. The findings will provide crucial evidence to support the implementation of HCL systems in selected pregnancies, leading to improved maternal and neonatal outcomes. By leveraging this advanced technology, we can enhance the health and well-being of women with T1D during this critical period.