{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T21:58:24Z","timestamp":1791669504389,"version":"4.3.4"},"reference-count":21,"publisher":"American Diabetes Association","issue":"8","license":[{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"name":"Medical Research Futures Fund","award":["2022\/MRF2023992"],"award-info":[{"award-number":["2022\/MRF2023992"]}]},{"name":"University of Calgary Clinical Research Fund"},{"name":"Mount Sinai Department of Medicine Research Fund"},{"name":"Buckley Family Trust"},{"name":"Diabetes Canada and MSI Foundation of Alberta","award":["End Diabetes 100 award 2021 grant OG-3-21-5570-LD"],"award-info":[{"award-number":["End Diabetes 100 award 2021 grant OG-3-21-5570-LD"]}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Following the demonstrated improvement in pregnancy glycemia with Control-IQ closed loop in the Closed-Loop Insulin Delivery by Glucose Responsive Computer Algorithms in Type 1 Diabetes Pregnancies\u00a0(CIRCUIT) trial, we compared intrapartum and early postpartum glycemic effectiveness and safety with standard care in type 1 diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>The primary outcome of this prespecified analysis was percentage of time in pregnancy-specific glucose range (63\u2013140 mg\/dL) during the 24 h prior to childbirth, measured by continuous glucose monitoring. A key secondary outcome was percentage of time at &amp;lt;70 mg\/dL in the first postpartum week, with additional secondary outcomes including continuous glucose monitoring metrics through 6 weeks postpartum. Analyses were adjusted for baseline measure, insulin delivery mode, and site.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>In the intrapartum period (24 h before delivery), 39 of 44 (89%) participants continued closed loop. Intravenous insulin was used intrapartum by one (2%) closed-loop participant and 20 (45%) standard-care participants (P &amp;lt; 0.001). Intrapartum closed-loop users spent more time in pregnancy-specific glucose range (79.6% vs. 64.8%) than the standard-care group (mean adjusted difference 13.2 percentage points; 95% CI 5.2, 21.2). In the first postpartum week, the closed-loop group spent less time &amp;lt;70 mg\/dL (1.7% vs. 3.2%; mean adjusted difference \u22121.8 percentage points; 95% CI \u22120.9 to \u22122.7) compared with the standard-care group. No maternal severe hypoglycemia occurred in the closed-loop group, while one episode occurred in the standard-care group postpartum. No diabetic ketoacidosis occurred in either group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Use of this closed-loop system resulted in superior intrapartum and early postpartum glycemia compared with standard care without safety concerns. Together with previous results, this supports use of this closed-loop system throughout pregnancy, labor, and the early postpartum period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title\/>\n                  <\/jats:sec>","DOI":"10.2337\/dc26-0470","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T16:51:15Z","timestamp":1779900675000},"page":"1339-1347","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":3,"title":["Intrapartum and Early Postpartum Use of Automated Insulin Delivery in Type 1 Diabetes: A Prespecified Analysis of the CIRCUIT Randomized Controlled Trial"],"prefix":"10.2337","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8911-8192","authenticated-orcid":false,"given":"Lois E.","family":"Donovan","sequence":"first","affiliation":[{"name":"Departments of Medicine and Obstetrics and Gynecology, Division of Endocrinology and Metabolism, Cumming School of Medicine, University of Calgary and Alberta Children\u2019s Hospital Research Institute 1 , Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4448-9437","authenticated-orcid":false,"given":"Patricia","family":"Lemieux","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Endocrinology and Nephrology, CHU de Quebec-Universit\u00e9 Laval Research Centre 2 , Quebec City, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3556-0820","authenticated-orcid":false,"given":"Jennifer M.","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Endocrinology and Metabolism, University of Manitoba and Children\u2019s Hospital Research Institute of Manitoba 3 , Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy D.","family":"Dunlop","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Endocrinology and Metabolism, Cumming School of Medicine, University of Calgary 4 , Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5489-0614","authenticated-orcid":false,"given":"Helen R.","family":"Murphy","sequence":"additional","affiliation":[{"name":"Norwich Medical School, University of East Anglia 5 , Norwich, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0261-0385","authenticated-orcid":false,"given":"Selina L.","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Medicine, Department of Obstetrics & Gynaecology, Division of Endocrinology and Metabolism, Schulich School of Medicine & Dentistry, Western University 6 , London, Ontario, 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A.","family":"Perkins","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Endocrinology and Metabolism, University of Toronto 14 , Toronto, Ontario, Canada"},{"name":"Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto and Sinai Health System 15 , Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Crawford","sequence":"additional","affiliation":[{"name":"Alberta Perinatal Health Program, Alberta Health Services, University of Calgary 16 , Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Tomlinson","sequence":"additional","affiliation":[{"name":"Institute for Health Policy, Management and Evaluation, Toronto General Hospital Research Institute, University of Toronto 17 , Toronto, Ontario, 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