Global Experts Endorse CGM and Automated Insulin Delivery for Diabetic Pregnancies

Pregnancy complicated by diabetes — whether pregestational type 1, type 2, or gestational — poses significant glycemic management challenges. Insulin resistance rises after the first trimester, increasing the risk of hyperglycemia and associated complications for both mother and child, including prenatal, perinatal, and long-term postnatal consequences. Despite these risks, over 95% of women with well-managed diabetes deliver healthy babies, underscoring the critical importance of effective glucose control strategies.

This international consensus statement, published in The Lancet Diabetes & Endocrinology, synthesizes available evidence and expert opinion on the use of CGM and AID technologies throughout the reproductive period. Authored by a global team spanning five continents and endorsed by 24 professional societies, the document carries substantial clinical authority.

For women with pregestational type 1 diabetes, the evidence base is strongest. CGM has demonstrated clear benefits in reducing pregnancy complications, and AID systems — which combine CGM with algorithmic insulin pump control — show increasing promise for optimizing glycemic management across the full reproductive window, from preconception through postpartum recovery.

For type 2 and gestational diabetes, the landscape is less settled. The consensus acknowledges that CGM-based glucose thresholds for diagnosing gestational diabetes and recommended time-in-range targets for routine management of these conditions have not yet been established, representing a key gap requiring future research and clinical validation.

The practical implications are significant: clinicians managing pregnant patients with any form of diabetes now have a globally endorsed framework to guide technology adoption. However, equitable access to these technologies — particularly in lower-resource settings represented among the authorship — remains a meaningful barrier. Large randomized controlled trials in pregnant populations are still needed to solidify the evidence base.