O-17 Clinical Case Report: Successful Pregnancy in a 41-Year-Old Woman With Type 1 Diabetes Using an Artificial Pancreas System

Abstract Introduction Type 1 diabetes mellitus (T1DM) presents challenges during pregnancy, including maternal and neonatal complications. Recent technology such as artificial pancreas systems (closed-loop insulin delivery) has improved glycaemic control and may enhance pregnancy outcomes. This report describes a 41-year-old woman with T1DM who experienced an uncomplicated pregnancy while using such a system. Clinical Case The patient is a 41-year-old woman with longstanding T1DM and no previous diabetes-related complications. Her preconception care involved regular endocrinology follow-ups and optimised glycaemic control. Pregnancy Management After confirming pregnancy, she chose to continue using a non-CE labelled artificial pancreas system. This device was not CE-approved nor endorsed by her clinic. It automated insulin delivery using continuous glucose monitoring, reducing self-management burden and glycaemic variability. Glycaemic Outcomes The patient's glycaemic control was excellent throughout pregnancy. Her HbA1c stayed at 39 mmol/mol (5.7%), and her time-in-range (70–180 mg/dL) was 90%, indicating near-normoglycaemia most of the time. She did not experience clinically significant hypoglycaemia. Obstetric Outcome The pregnancy progressed to 36 weeks without complications, despite the potential high-risk factors (duration of T1DM, age). Delivery followed preterm rupture of membranes, and due to GBS positivity, a caesarean section was performed after 11 hours. The operation was uneventful. Neonatal Outcome The newborn did not require glucose infusion after birth, indicating stable glycaemia. The baby showed normal growth and development in the first year, without adverse events or developmental concerns. This case demonstrates the potential of artificial pancreas systems in pregnancy management for T1DM, with excellent glycaemic control, low HbA1c, and high time-in-range. These factors contributed to the absence of maternal and neonatal complications, such as neonatal hypoglycaemia. The child’s normal development supports the safety and efficacy of this strategy. However, the system was not CE approved or clinic recommended. Conclusion The artificial pancreas system—used without CE approval or clinic endorsement—enabled optimal glycaemic control and a successful pregnancy with healthy neonatal outcome in a woman with T1DM. This report adds to evidence supporting advanced diabetes technologies in pregnancy, while highlighting the need for regulatory approval and clinical guidance.