Conclusions
Emerging technologies in the treatment of type 1 diabetes in pregnancy including CGM, insulin pumps and most recently sensor-integrated insulin delivery show promise in the management of this challenging condition. However, barriers such as cost and the education necessary for each technology must also be considered. The speed of the progress of these technologies offers improvements in accuracy, performance and device burdens associated with their use but also makes it challenging for clinicians to keep up with this ever-changing landscape. An understanding of the current literature is essential, as previously done studies with older devices may not be generalisable to the latest technologies. It also challenges clinicians and women with diabetes to understand and expertly use the various new systems.
Many women with type 1 diabetes put in a tremendous effort in managing their diabetes and may face feelings of concern when their glucose is out of target, pressure to achieve optimal glycaemic control, concern regarding previous pregnancy complications and a desire for a “normal” pregnancy [40, 41]. Despite this, many are unable to achieve guidelinerecommended glycaemic targets [6••]. We must find treatments for diabetes that are effective but not all consuming. Technology in the treatment of diabetes may allow us to do so, but there is still much work to be done. It is essential that research continues to keep a fast pace as technology advances and that the perspective of women with type 1 diabetes be taken into consideration as we move forward. The latest evidence suggests that CGM should be offered to all women on intensive insulin therapy. Future research is needed to optimise glucose control before pregnancy and to understand which women are candidates for sensor-integrated insulin delivery.
