Endocrine Abstracts

Hybrid closed-loop systems providing automated glucose responsive insulin delivery are set to revolutionise the management of type 1 diabetes. However, pregnancy poses formidable challenges, including more stringent glucose targets, gestational changes in insulin sensitivity and day to day variations in insulin pharmacokinetics. Therefore, hybrid closed-loop systems that are effective outside pregnancy, cannot guarantee clinically relevant glycaemic benefits throughout pregnancy. In this session, I summarise the evidence from two pivotal randomised trials, suggesting that the benefits of hybrid closed-loop therapy during type 1 diabetes pregnancy are system-specific, with only one system offering clinical benefits to a generalisable patient population, regardless of previous technology use and across all maternal HbA1c categories. There are stark inequalities in diabetes technology access, and an urgent unmet need for high quality data in women of reproductive years living with type 2 diabetes, who now outnumber those with type 1 diabetes.