New guidance on 'artificial pancreas' technology for pregnant women with type 1 diabetes

The National Institute for Health and Care Excellence (NICE) has issued draft guidance urging the NHS to offer pregnancy-specific hybrid closed loop (HCL) systems to all women with type 1 diabetes from the moment they begin planning a pregnancy. These devices, also known as 'artificial pancreas' technology, continuously monitor blood sugar levels and deliver insulin via a wearable pump, eliminating the need for frequent finger-prick tests and manual injections. The recommendation comes ahead of Diabetes Awareness Week and aims to address the critical challenge of managing blood sugar during pregnancy, where unstable levels can lead to miscarriage, premature birth, or complications during labor. Clinical trials demonstrate that pregnancy-specific HCL systems help women maintain safer blood sugar ranges throughout pregnancy, improving outcomes for both mother and baby. Under the proposed guidelines, specialist multidisciplinary teams must provide training and support for women using the technology, which can also be continued during labor if clinically safe and agreed upon in advance. Women may opt to use the system for at least six months postpartum. The guidance specifies that the HCL system must be licensed for pregnancy use, allow blood sugar targets within pregnancy ranges, and deliver at least 5% more time in the safe glucose range compared to standard care. Eric Power, interim director of NICE’s Centre for Guidelines, highlighted the impact of the recommendation, stating that thousands of women with type 1 diabetes give birth annually in England and Wales. He emphasized that the evidence supports these systems as a meaningful improvement in care, helping women spend significantly more time within safe blood sugar levels. Dr. Marie Anne Ledingham, a consultant obstetrician and NICE clinical adviser, noted that women with type 1 diabetes face immense emotional and physical strain during pregnancy due to constant blood sugar monitoring and insulin adjustments. She observed that pregnancy-specific HCL systems reduce exhaustion, improve sleep, and boost confidence, as reflected in better blood sugar data. The draft recommendations establish a clear framework for offering this technology early in pregnancy planning, alongside necessary training and support.