{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:45:22Z","timestamp":1792053922993,"version":"4.4.0"},"reference-count":29,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>\n                      This qualitative inquiry aimed to explore the lived experiences of pregnant women with self\u2010management of type 1 diabetes (T1D) using closed\u2010loop insulin delivery in the CIRCUIT trial\n                      <jats:sup>9<\/jats:sup>\n                      to provide a qualitative overview of its impacts and improve the understanding of T1D experiences in pregnancy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used semi\u2010structured, individual interviews with 18 CIRCUIT randomized trial participants. Two team members analysed verbatim transcripts using inductive thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four major themes emerged: 1. Independence and isolation; 2. Support is key; 3. Closed\u2010loop impacts; and 4. Control and autonomy. Diabetes management during pregnancy was an emotionally overwhelming experience that was managed largely independently. Closed\u2010loop was noted as a gamechanger for diabetes management during and after pregnancy. Participants felt the transition to and use of this technology would not have been possible without their healthcare team's support. Permeating all themes was the importance of control to achieve the best possible glycaemic outcomes for the health of their babies and autonomy over personal treatment decisions. The perceptions of loss of personal autonomy were associated with high anxiety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Managing T1D while pregnant is an independent and isolating endeavour, due to the \u2018invisible labour\u2019 involved and the lack of knowledge about T1D management in personal networks. Support from partners and care providers alleviated stress. Experiences with intrapartum care providers who had limited T1D understanding were perceived as a challenge by some for maintaining autonomy. The closed\u2010loop system was seen as a \u2018gamechanger\u2019 in T1D pregnancy management, with unanimous perception of positive impacts that far outweigh any challenges. Use of this closed\u2010loop system has potential to vastly improve pregnancy experiences among those with T1D.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dme.70388","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T16:00:04Z","timestamp":1781193604000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A qualitative enquiry into the lived experiences of women with type 1 diabetes using closed\u2010loop insulin delivery in pregnancy in the\n                    <scp>CIRCUIT<\/scp>\n                    trial"],"prefix":"10.1111","volume":"43","author":[{"given":"J.","family":"Hirtle","sequence":"first","affiliation":[{"name":"Department of Community Health Sciences, Cumming School of Medicine University of Calgary  Calgary Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Goraya","sequence":"additional","affiliation":[{"name":"Undergraduate Medical Education, Cumming School of Medicine University of Calgary  Calgary Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Dunlop","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Endocrinology and Metabolism, Cumming School of Medicine University of Calgary  Calgary Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Booth","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Endocrinology and Metabolism, Cumming School of Medicine University of Calgary  Calgary Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8561-7584","authenticated-orcid":false,"given":"D. S.","family":"Feig","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Endocrinology University of Toronto and the Lunenfeld Tannenbaum Research Institute, Mount Sinai Hospital  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Community Health Sciences and Children's Hospital Research Institute of Manitoba University of Manitoba  Winnipeg Manitoba Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8911-8192","authenticated-orcid":false,"given":"L. E.","family":"Donovan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Endocrinology and Metabolism, Cumming School of Medicine University of Calgary  Calgary Canada"},{"name":"Department of Obstetrics and Gynecology, Cumming School of Medicine University of Calgary  Calgary Canada"},{"name":"Alberta Children's Hospital Research Institute University of Calgary  Calgary Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7596-6019","authenticated-orcid":false,"given":"K. H.","family":"Chaput","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences, Cumming School of Medicine University of Calgary  Calgary Canada"},{"name":"Department of Obstetrics and Gynecology, Cumming School of Medicine University of Calgary  Calgary Canada"},{"name":"Alberta Children's Hospital Research Institute University of Calgary  Calgary Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"For the CIRCUIT Collaborative 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