Enhanced Glycemic Management in Pregnancy: The Role of Closed-Loop Insulin Systems

A multicenter randomized clinical trial involving 94 pregnant women with type 1 diabetes found that closed-loop insulin systems improved glycemic control in pregnancy, increasing time-in-range (TIR) to 65.4% versus 50.3% with standard care.

Maternal markers shifted favorably: HbA1c fell at 24 and 34 weeks, and the closed-loop arm had fewer preeclampsia events. Lower antenatal HbA1c and reduced preeclampsia incidence are linked to lower maternal morbidity and improved neonatal outcomes, suggesting that better perinatal glycemic control may translate into meaningful clinical benefit.

Safety data showed fewer hypoglycemic events and reduced glycemic variability in the closed-loop group, with no unexpected safety signals identified. The trial also noted generally favorable neonatal findings while flagging specific neonatal outcome differences that require further evaluation.

These results support consideration of closed-loop systems as a strategy to improve perinatal glycemic management while continuing vigilance for less common neonatal events.