{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T07:01:16Z","timestamp":1790146876242,"version":"4.0.1"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"vor","delay-in-days":264,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Diabetes Research"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Automated insulin delivery (AID) has moved rapidly from experimental use to emerging clinical implementation in pregnancy complicated by type 1 diabetes. Randomised trials now show that selected systems can improve pregnancy\u2010specific continuous glucose monitoring outcomes, particularly time in range and overnight glycaemic stability, but the evidence is system\u2010specific rather than class\u2010wide and remains underpowered for definitive maternal and neonatal endpoints. This integrative review synthesises clinical trial, observational, qualitative, implementation, policy and equity evidence to examine how AID can be translated into safe, equitable and sustainable perinatal diabetes care. We argue that AID in pregnancy is best understood as a socio\u2010technical intervention: its effectiveness depends on the interaction between algorithm design, pregnancy physiology, user\u2010device behaviours, education, workforce capability, antenatal workflows, delivery planning, postpartum dose reduction and access to specialist support. We summarise system\u2010specific evidence for CamAPS FX, MiniMed 780G and Tandem Control\u2010IQ, review gaps in maternal and neonatal outcome data and propose a practical implementation framework spanning patient, device, clinician, service and health\u2010system levels. The review also presents a reproductive\u2010stage care pathway from preconception to postpartum and identifies equity risks across high\u2010income and lower\u2010resource settings. The field has moved beyond asking whether selected AID systems improve glucose metrics; the next responsibility is to determine how services can deliver these benefits safely, affordably and equitably for the pregnant people most likely to benefit.<\/jats:p>","DOI":"10.1155\/jdr\/1989683","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:16:16Z","timestamp":1790144176000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Automated Insulin Delivery in Pregnancy With Type 1 Diabetes: An Integrative Review of Clinical Evidence, Socio\u2010Technical Implementation and Equity"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-1416-5354","authenticated-orcid":false,"given":"Jieli","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3767-7335","authenticated-orcid":false,"given":"Tina Nan","family":"Qi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8129-3770","authenticated-orcid":false,"given":"Xiangmin","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5959-2723","authenticated-orcid":false,"given":"Rasika","family":"Jayasekara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"e_1_2_19_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32400-5"},{"key":"e_1_2_19_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2303911"},{"key":"e_1_2_19_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(24)00089-5"},{"key":"e_1_2_19_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2025.19578"},{"key":"e_1_2_19_5_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2024.0012"},{"key":"e_1_2_19_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1602494"},{"key":"e_1_2_19_7_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc17-2534"},{"key":"e_1_2_19_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(25)00335-3"},{"key":"e_1_2_19_9_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2023.0323"},{"key":"e_1_2_19_10_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2022.0479"},{"key":"e_1_2_19_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13406"},{"key":"e_1_2_19_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eprac.2025.01.005"},{"key":"e_1_2_19_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/19322968251329288"},{"key":"e_1_2_19_14_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2022.0540"},{"key":"e_1_2_19_15_2","volume-title":"Hybrid Closed Loop Systems for Managing Blood Glucose Levels in Type 1 Diabetes. Technology Appraisal Guidance TA943","author":"National Institute for Health and Care Excellence","year":"2023"},{"key":"e_1_2_19_16_2","volume-title":"Hybrid Closed Loop Technologies: 5-Year Implementation Strategy","author":"NHS England","year":"2024"},{"key":"e_1_2_19_17_2","volume-title":"510(k) Substantial Equivalence Determination Decision Summary: CamAPS FX (K232603)","author":"US Food and Drug Administration","year":"2024"},{"key":"e_1_2_19_18_2","volume-title":"Tandem Diabetes Care\u2032s Control-IQ+ Automated Insulin Delivery Technology Now FDA Cleared for Pregnancy in Type 1 Diabetes","author":"Tandem Diabetes Care","year":"2026"},{"key":"e_1_2_19_19_2","volume-title":"Mylife Diabetes Care Australia Pty Ltd-CamAPS FX\u2014Ambulatory Insulin Infusion Pump Software, Patient-Dosing (ARTG ID 489066)","author":"Therapeutic Goods Administration","year":"2025"},{"key":"e_1_2_19_20_2","unstructured":"National Diabetes Services Scheme Type 1 Diabetes: Pregnancy Planning 2026 https:\/\/www.ndss.com.au\/about-the-ndss\/cgm-access\/type-1-diabetes-pregnancy\/."},{"key":"e_1_2_19_21_2","doi-asserted-by":"crossref","DOI":"10.2471\/B09615","volume-title":"WHO Recommendations on Care for Women With Diabetes During Pregnancy","author":"World Health Organization","year":"2025"},{"key":"e_1_2_19_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/hcs2.89"},{"key":"e_1_2_19_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/dme.15089"},{"key":"e_1_2_19_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/dme.14891"},{"key":"e_1_2_19_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2025.103106"},{"key":"e_1_2_19_26_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc26-S015"},{"key":"e_1_2_19_27_2","doi-asserted-by":"publisher","DOI":"10.1177\/19322968251330651"},{"key":"e_1_2_19_28_2","doi-asserted-by":"publisher","DOI":"10.1111\/dme.15086"},{"key":"e_1_2_19_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(24)00340-1"}],"container-title":["Journal of Diabetes Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/jdr\/1989683","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/jdr\/1989683","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/jdr\/1989683","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:16:20Z","timestamp":1790144180000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/jdr\/1989683"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":29,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/jdr\/1989683"],"URL":"https:\/\/doi.org\/10.1155\/jdr\/1989683","archive":["Portico"],"relation":{},"ISSN":["2314-6745","2314-6753"],"issn-type":[{"value":"2314-6745","type":"print"},{"value":"2314-6753","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-06-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"1989683"}}