Pregnancy fundamentally alters glucose metabolism, creating a delicate balancing act for millions of women worldwide who develop or already live with diabetes. The stakes extend beyond maternal health—poor glucose control during pregnancy can trigger complications that affect both mother and child for decades. This international consensus represents a pivotal moment in applying cutting-edge diabetes technology to one of medicine's most complex metabolic challenges.
The statement endorses continuous glucose monitoring (CGM) for women with pre-existing type 1 diabetes during preconception and pregnancy, citing compelling evidence for reduced complications. For automated insulin delivery systems—sophisticated devices that adjust insulin based on real-time glucose readings—the panel found promising but limited data specifically in pregnant populations with type 1 diabetes. The consensus acknowledges significant knowledge gaps, particularly around optimal glucose thresholds for diagnosing gestational diabetes using CGM and establishing time-in-range targets for managing gestational and type 2 diabetes during pregnancy.
This measured endorsement reflects the conservative approach required when evaluating technologies in pregnancy, where safety considerations multiply. While CGM and automated systems have transformed diabetes management in general populations, pregnancy introduces unique physiological changes that may alter device performance and therapeutic targets. The consensus highlights a critical research priority: large randomized controlled trials specifically designed for pregnant populations. Until such studies are completed, clinicians must balance the known benefits of these technologies against the uncertainty of pregnancy-specific outcomes, making individualized care decisions that could reshape how we approach diabetes in pregnancy.