New Automated Insulin Delivery System Shows Major Benefits for Pregnant Women with Type 1 Diabetes

Pregnancy is already a delicate journey — but for women living with Type 1 diabetes, it becomes a daily battle to keep glucose levels within a safe range. A new international study, co-led by University of Calgary researchers, now offers a breakthrough solution: automated insulin delivery (AID) technology that mimics the natural function of a healthy pancreas.

This advanced system, which continually adjusts insulin doses in real time, has shown remarkable improvements in glucose control during pregnancy. The findings, published in JAMA, are being celebrated as a major milestone in maternal-fetal health for women with Type 1 diabetes.

A major step forward in diabetes management during pregnancy

Dr. Lois Donovan, an endocrinologist at Foothills Medical Centre and co-principal investigator of the study, emphasized the significance of the results. She explained that maintaining healthy blood glucose during pregnancy is essential because both the mother and the developing fetus face increased risks when glucose levels fluctuate.

The clinical trial compared a hybrid closed-loop (HCL) insulin therapy system with standard insulin injections and non-automated pumps. The difference was clear: women using the AID system achieved three extra hours per day within the ideal glucose range.

Dr. Denice Feig, the study’s other co-principal investigator from the University of Toronto, highlighted the daily challenges pregnant women face. Even with strong support from healthcare teams, reaching stable glucose levels is extremely difficult due to hormonal changes and rising insulin needs during pregnancy. This new technology helps bridge that gap.

Why glucose control matters

Pregnancy with Type 1 diabetes carries several risks, including:

• Higher chances of miscarriage
• Increased risk of preeclampsia
• Premature delivery
• Babies born too large or with low blood sugar
• Greater risk of congenital anomalies

Previous research has shown that even small improvements in glucose control make a big difference. For example, every additional 72 minutes per day spent in the target glucose range can reduce complications in newborns. The AID system in this study provided nearly three times that amount — a game-changing improvement.

How the automated insulin delivery system works

The system used in the study — the Tandem t:slim X2 insulin pump with Control-IQ technology — is designed to automatically regulate insulin based on predicted glucose trends. While AID systems have been successful for non-pregnant individuals, most were not originally designed for the tight glucose targets required during pregnancy or the rapid hormonal shifts women experience.

This study is the first large-scale trial to demonstrate that AID can meet those demanding needs.

Global participation and consistent results

The trial involved 14 clinical sites across Canada and Australia, including Calgary, Toronto, Vancouver, Winnipeg, Quebec City, Melbourne, and Sydney. Results were consistent across all locations: women using AID spent more time within healthy glucose levels and less time above or below the range. The improvements were immediate and sustained throughout pregnancy.

Dr. Feig noted that these findings will help women who are pregnant or planning pregnancy understand how AID systems can support better glucose control and improved outcomes for themselves and their babies.

Supported by major health organizations

Funding for the research came from Diabetes Canada, MSI Foundation, University of Calgary Clinical Research Fund, and several institutional partners. Additional support, such as reduced-cost supplies, was provided by Dexcom Canada, Tandem Diabetes Care, and RxFood. Australia’s Medical Research Future Fund also contributed to the trial.

A promising future for diabetes care in pregnancy

This study represents a major advancement in maternal healthcare technology. With better tools for maintaining stable glucose levels, women with Type 1 diabetes now have stronger support in achieving safer pregnancies and healthier newborn outcomes.

As AID systems continue to evolve, this breakthrough sets a new standard for diabetes management and offers hope to thousands of families worldwide.