Maternal and neonatal outcomes in pregnancies complicated by type 1 diabetes using hybrid closed-loop insulin delivery: a case series

Ciara Coveney; Eimear Rutter; Hannah Rooney; Claire-Daisy O; Catherine Chambers; Rhona Mahony; Jennifer Walsh; Mary Higgins; Mensud Hatunic

doi:10.1530/endoabs.115.PCR16

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Endocrine Abstracts (2026) 115 PCR16 | DOI: 10.1530/endoabs.115.PCR16

IES2025 Case Reports Physical Posters (18 abstracts)

Maternal and neonatal outcomes in pregnancies complicated by type 1 diabetes using hybrid closed-loop insulin delivery: a case series

Ciara Coveney ¹ , Eimear Rutter ¹ , Hannah Rooney ¹ , Claire-Daisy O’Reilly1 , Catherine Chambers ¹ , Rhona Mahony ¹ , Jennifer Walsh ¹ , Mary Higgins ¹ & Mensud Hatunic ^1,2

Author affiliations

¹National Maternity Hospital, Dublin, Ireland,; ²Mater Misericordiae University Hospital, Dublin, Ireland

Pregnancy in individuals with Type 1 Diabetes (T1D) requires intensive management to reduce complications mother and infant. Hybrid closed-loop (HCL) systems offer automation and real-time glucose data, real-world pregnancy outcome data remain limited. We reviewed glycaemic control, obstetric characteristics, delivery outcomes, and neonatal outcomes in a cohort of nine pregnant individuals with T1D using HCL over a 14-months May 2024 - July 2025. Most participants were multiparous mean age of 34 years. HCL were used throughout pregnancy including delivery. Booking mean Hba1c was; 44 mmol/mol and values ranged from; 34 mmol/mol to 61 mmol/mol. There was improved glycaemic control in late pregnancy mean HbA1c; 38 mmol/mol in; 3rd trimester (SD = 5.1), significantly below the target of 48 mmol/mol (t(8) = −5.10, P < 0.001). No episodes of severe hypoglycaemia or diabetic ketoacidosis occurred during pregnancy, labour, or the postnatal period. Term delivery was achieved in all but one case (36+6 weeks), mean gestational age at delivery of 38+3 weeks. All women were delivered by caesarean section. Mean neonatal birthweight was 3.3kg, range 3.2 kg -5.0 kg. Admission to NICU was observed in 33.3% of neonates born. Neonatal hypoglycaemia occurred in 11% of cases managed without major complications. No stillbirths, neonatal deaths, or significant congenital anomalies were recorded. Use of HCL insulin delivery systems during pregnancy appears safe and is associated with favourable maternal and neonatal outcomes in individuals with T1D. These findings reinforce the potential benefits of automated insulin delivery in pregnancy and support further prospective comparative studies in this area.