Diabetes Care Commentary Calls for Pregnancy-Specific Automated Insulin Delivery

A commentary in Diabetes Care calls for automated insulin delivery (AID) systems that address pregnancy-specific glycemic targets in women with type 1 diabetes. These targets are lower than those outside pregnancy and difficult to achieve, creating substantial treatment burden and psychosocial distress. The available abstract presents an advocacy argument rather than a new clinical study.

The authors state that AID systems approved by the U.S. Food and Drug Administration are not designed to meet pregnancy glycemic targets, and most are not labeled for pregnancy. They also note that most devices reduce insulin delivery when continuous glucose monitoring values are within the range considered optimal for fetal well-being. Broad exclusion of pregnant participants from clinical trials has left limited evidence to guide device use in this population.

The commentary urges stakeholders to include pregnant women in trials of new AID technologies, develop systems suited to pregnancy, and support real-world studies of currently approved devices. These proposals address a clinically important evidence and design gap, but the abstract provides no comparative efficacy or safety estimates and does not establish which existing systems should be used during pregnancy. Full text was not available for assessment.