Original Investigation

Closed-Loop Insulin Delivery in Type 1 Diabetes in Pregnancy

JAMA 10.1001/jama.2025.19578

October 24, 2025 at 10:50 AM EDT

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What is the efficacy of a closed-loop insulin delivery system compared with standard insulin with continuous glucose monitoring in pregnant women with type 1 diabetes?In this multicenter randomized clinical trial of 94 pregnant women with type 1 diabetes, the mean percentage of time spent in the pregnancy-specific glucose range (63-140 mg/dL) from 16 to 34 weeks’ gestation was 65.4% in the closed-loop system group and 50.3% in the standard insulin delivery with continuous glucose monitoring group, a statistically significant difference.The findings support use of this closed-loop system in pregnant women with type 1 diabetes.

Corresponding Author: Lois E. Donovan, MD, University of Calgary, Richmond Road Diagnostic and Treatment Centre, 1820 Richmond Rd SW, Calgary, AB T2T 5C7, Canada (lois.donovan@ahs.ca).

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