{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T08:57:28Z","timestamp":1791017848580,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T00:00:00Z","timestamp":1790985600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T00:00:00Z","timestamp":1790985600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100014196","name":"Sahlgrenska University Hospitals Research Foundations","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100014196","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007687","name":"Svenska L\u00e4kares\u00e4llskapet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007687","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100017138","name":"Health and Medical Care Committee of the Regional Executive Board, Region V\u00e4stra G\u00f6taland","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100017138","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"abstract":"Abstract<\/jats:title>\n \n Aims<\/jats:title>\n To investigate the clinical use, in early pregnancy in women living with type 1 diabetes (T1D), of automated insulin delivery (AID) systems lacking pregnancy\u2010specific algorithms and to evaluate the maternal and glycaemic outcomes associated with their implementation in routine care.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This observational study included women with T1D who used off\u2010label AID pumps during pregnancy. The AID pumps were switched to manual mode during the second trimester.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of the 37 women, 25 used the Tandem Control IQ, and 12 used the MiniMed 780G. The median age was 30.5 (28.0\u201334.0) years. Automatic functions were activated until the median gestational age was 18.9\u2009weeks. Mean time in range pregnancy (TIRp) was 65.0%, 70.1% and 76.5% in the first, second and third trimesters, respectively. Only 10 women (27.0%) reached TIRp >70% in all trimesters. 34 women (91.9%) were prescribed adjunctive treatment with long\u2010acting insulin. 18 women (49%) delivered with caesarean section, and 12 (32.4%) had newborns large for gestational age.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This small observational cohort showed no major safety signals among women using AID pumps during early pregnancy or during the second and third trimesters when manual mode was combined with adjunctive long\u2010acting insulin. In this cohort, we also observed favourable glycaemic outcomes in later pregnancy, when most AID systems were used almost exclusively in manual mode.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/dme.70483","type":"journal-article","created":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T08:47:52Z","timestamp":1791017272000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real\u2010world use of automatic insulin delivery pumps in early pregnancy among women living with type 1 diabetes"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1119-5267","authenticated-orcid":false,"given":"Sara","family":"Hallstr\u00f6m","sequence":"first","affiliation":[{"name":"Department of Medicine, Geriatrics and Emergency Care Sahlgrenska University Hospital Gothenburg Region V\u00e4stra G\u00f6taland Sweden"},{"name":"Department of Molecular and Clinical Medicine Institute of Medicine, University of Gothenburg Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrika","family":"Sandgren","sequence":"additional","affiliation":[{"name":"Department of Medicine, Geriatrics and Emergency Care M\u00f6lndal Sahlgrenska University Hospital Gothenburg Region V\u00e4stra G\u00f6taland Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3796-9283","authenticated-orcid":false,"given":"Marcus","family":"Lind","sequence":"additional","affiliation":[{"name":"Department of Medicine, Geriatrics and Emergency Care Sahlgrenska University Hospital Gothenburg Region V\u00e4stra G\u00f6taland Sweden"},{"name":"Department of Molecular and Clinical Medicine Institute of Medicine, University of Gothenburg Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,3]]},"reference":[{"issue":"3","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/S2213-8587(20)30406-X","article-title":"Characteristics and outcomes of pregnant women with type 1 or type 2 diabetes: a 5\u2010year national population\u2010based cohort study","volume":"9","author":"Murphy HR","year":"2021","journal-title":"Lancet Diabetes Endocrinol"},{"key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"3191","DOI":"10.1111\/apa.70230","article-title":"Neonatal outcomes among neonates of women with and without type 1 diabetes in Sweden from 2010 to 2022","volume":"114","author":"Goldberg A","year":"2025","journal-title":"Acta Paediatr"},{"issue":"7","key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1007\/s00125-019-4904-3","article-title":"Continuous glucose monitoring targets in type 1 diabetes pregnancy: every 5% time in range matters","volume":"62","author":"Murphy HR","year":"2019","journal-title":"Diabetologia"},{"issue":"1","key":"e_1_2_11_5_1","first-page":"S282","article-title":"15. Management of diabetes in pregnancy: standards of care in diabetes\u20142024","volume":"47","year":"2024","journal-title":"Diabetes Care"},{"key":"e_1_2_11_6_1","doi-asserted-by":"crossref","DOI":"10.3389\/fendo.2020.611929","article-title":"Nutrition and metabolic adaptations in physiological and complicated pregnancy: focus on obesity and gestational diabetes","volume":"11","author":"Parrettini S","year":"2020","journal-title":"Front Endocrinol"},{"key":"e_1_2_11_7_1","unstructured":"VinturacheA KhalilA.Maternal physiological changes in pregnancy. The Continuous Textbook of Women's Medicine Series\u2013Obstetrics Module; 2021."},{"issue":"8","key":"e_1_2_11_8_1","doi-asserted-by":"crossref","first-page":"1593","DOI":"10.2337\/dci19-0028","article-title":"Clinical targets for continuous glucose monitoring data interpretation: recommendations from the international consensus on time in range","volume":"42","author":"Battelino T","year":"2019","journal-title":"Diabetes Care"},{"issue":"10110","key":"e_1_2_11_9_1","doi-asserted-by":"crossref","first-page":"2347","DOI":"10.1016\/S0140-6736(17)32400-5","article-title":"Continuous glucose monitoring in pregnant women with type 1 diabetes (CONCEPTT): a multicentre international randomised controlled trial","volume":"390","author":"Feig DS","year":"2017","journal-title":"Lancet"},{"issue":"7","key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1007\/s00125-019-4850-0","article-title":"Continuous glucose monitoring in pregnant women with type 1 diabetes: an observational cohort study of 186 pregnancies","volume":"62","author":"Kristensen K","year":"2019","journal-title":"Diabetologia"},{"issue":"4","key":"e_1_2_11_11_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajog.2024.01.010","article-title":"Continuous glucose monitoring in pregnancies with type 1 diabetes: small increases in time\u2010in\u2010range improve maternal and perinatal outcomes","volume":"231","author":"Sobhani NC","year":"2024","journal-title":"Am J Obstet Gynecol"},{"issue":"10","key":"e_1_2_11_12_1","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1089\/dia.2021.0073","article-title":"Continuous glucose monitoring time\u2010in\u2010range and HbA1c targets in pregnant women with type 1 diabetes","volume":"23","author":"Tundidor D","year":"2021","journal-title":"Diabetes Technol Ther"},{"issue":"18","key":"e_1_2_11_13_1","doi-asserted-by":"crossref","first-page":"1707","DOI":"10.1056\/NEJMoa1907863","article-title":"Six\u2010month randomized. Multicenter trial of closed\u2010loop control in type 1 diabetes","volume":"381","author":"Brown SA","year":"2019","journal-title":"N Engl J Med"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/19322968241242386"},{"issue":"3","key":"e_1_2_11_15_1","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1089\/dia.2023.0442","article-title":"Real\u2010world evidence of automated insulin delivery system use","volume":"26","author":"Considine EG","year":"2024","journal-title":"Diabetes Technol Ther"},{"key":"e_1_2_11_16_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.eclinm.2024.102852","article-title":"Effect of automated insulin delivery systems on person\u2010reported outcomes in people with diabetes: a systematic review and meta\u2010analysis","volume":"76","author":"Roos T","year":"2024","journal-title":"EClinicalMedicine"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2025.19578"},{"issue":"17","key":"e_1_2_11_18_1","doi-asserted-by":"crossref","first-page":"1566","DOI":"10.1056\/NEJMoa2303911","article-title":"Automated insulin delivery in women with pregnancy complicated by type 1 diabetes","volume":"389","author":"Lee TT","year":"2023","journal-title":"N Engl J Med"},{"issue":"6","key":"e_1_2_11_19_1","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1016\/S2213-8587(24)00089-5","article-title":"Comparing advanced hybrid closed loop therapy and standard insulin therapy in pregnant women with type 1 diabetes (CRISTAL): a parallel\u2010group. Open\u2010label. Randomised controlled trial","volume":"12","author":"Benhalima K","year":"2024","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"4","key":"e_1_2_11_20_1","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1177\/15209156251379488","article-title":"A real\u2010world study comparing advanced hybrid closed\u2010loop systems during pregnancy in women with type 1 diabetes","volume":"28","author":"Quir\u00f3s C","year":"2026","journal-title":"Diabetes Technol Ther"},{"issue":"4","key":"e_1_2_11_21_1","doi-asserted-by":"crossref","DOI":"10.1111\/dme.14743","article-title":"A study of diabetic ketoacidosis in the pregnant population in the United Kingdom: investigating the incidence. Aetiology. Management and outcomes","volume":"39","author":"Diguisto C","year":"2022","journal-title":"Diabet Med"},{"issue":"2","key":"e_1_2_11_22_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmjdrc-2020-001329","article-title":"Causes of diabetic ketoacidosis among adults with type 1 diabetes mellitus: insulin pump users and non\u2010users","volume":"8","author":"Flores M","year":"2020","journal-title":"BMJ Open Diabetes Res Care"},{"issue":"6","key":"e_1_2_11_23_1","doi-asserted-by":"crossref","first-page":"1764","DOI":"10.1152\/ajplegacy.1976.231.6.1764","article-title":"Acid\u2010base regulation in pregnancy","volume":"231","author":"Lim VS","year":"1976","journal-title":"Am J Physiol"},{"issue":"8","key":"e_1_2_11_24_1","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1111\/j.1651-2227.1991.tb11945.x","article-title":"An update of the Swedish reference standards for weight. Length and head circumference at birth for given gestational age (1977\u20131981)","volume":"80","author":"Niklasson A","year":"1991","journal-title":"Acta Paediatr Scand"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/19322968251327603"},{"issue":"7","key":"e_1_2_11_26_1","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1089\/dia.2023.0031","article-title":"Real\u2010world insulin treatment in pregnant women with type 1 diabetes using an advanced hybrid closed\u2010loop system","volume":"25","author":"Dodesini AR","year":"2023","journal-title":"Diabetes Technol Ther"},{"issue":"12","key":"e_1_2_11_27_1","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1089\/dia.2023.0267","article-title":"MiniMed\u2122 780G advanced hybrid closed\u2010loop system study in pregnant women with type 1 diabetes","volume":"25","author":"Guibert C","year":"2023","journal-title":"Diabetes Technol Ther"},{"issue":"8","key":"e_1_2_11_28_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.jdiacomp.2024.108795","article-title":"Real\u2010world data on the Minimed 780G advanced hybrid closed\u2010loop system use during type 1 diabetes pregnancy: one centre observational study","volume":"38","author":"Munda A","year":"2024","journal-title":"J Diabetes Complications"},{"issue":"6","key":"e_1_2_11_29_1","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/S2213-8587(20)30114-5","article-title":"Flexible insulin therapy with a hybrid regimen of insulin degludec and continuous subcutaneous insulin infusion with pump suspension before exercise in physically active adults with type 1 diabetes (FIT untethered): a single\u2010centre. Open\u2010label. Proof\u2010of\u2010concept. Randomised crossover trial","volume":"8","author":"Aronson R","year":"2020","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"10","key":"e_1_2_11_30_1","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1007\/s00592-024-02264-7","article-title":"An \u201cout of the box\u201d approach for prevention of ketoacidosis in youth with poorly controlled type 1 diabetes: combined use of insulin pump and long\u2010acting insulin","volume":"61","author":"Barash G","year":"2024","journal-title":"Acta Diabetol"},{"key":"e_1_2_11_31_1","article-title":"Factors affecting the absorption of subcutaneously administered insulin: effect on variability","volume":"2018","author":"Gradel AKJ","year":"2018","journal-title":"J Diabetes Res"},{"issue":"12","key":"e_1_2_11_32_1","doi-asserted-by":"crossref","first-page":"2502","DOI":"10.2337\/dc10-1126","article-title":"Dose\u2010dependent delay of the hypoglycemic effect of short\u2010acting insulin analogs in obese subjects with type 2 diabetes: a pharmacokinetic and pharmacodynamic study","volume":"33","author":"Gagnon\u2010Auger M","year":"2010","journal-title":"Diabetes Care"}],"container-title":["Diabetic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.70483","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/dme.70483","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.70483","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T08:47:56Z","timestamp":1791017276000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dme.70483"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,3]]},"references-count":31,"alternative-id":["10.1111\/dme.70483"],"URL":"https:\/\/doi.org\/10.1111\/dme.70483","archive":["Portico"],"relation":{},"ISSN":["0742-3071","1464-5491"],"issn-type":[{"value":"0742-3071","type":"print"},{"value":"1464-5491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,3]]},"assertion":[{"value":"2026-04-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70483"}}