2163-P: Safety and Effectiveness of Automated Insulin Delivery during Labor and the Postpartum Period

Introduction and Objective: Intravenous (IV) insulin infusion is the standard of care for glucose management during labor and delivery in women with type 1 diabetes. Limited real-world data are available on the safety and effectiveness of automated insulin delivery (AID) during labor and the post-partum period. Methods: This retrospective cohort study compared glycemic outcomes between patients who used an AID and those who received IV insulin infusion or multiple daily injections (MDI) during labor and delivery. We calculated mean glucose level, time in range (TIR, 65-140 mg/dl before delivery, 70-180 mg/dl post-partum), and time hypoglycemic (<54 mg/dl). Results: Among 58 patients, 35 remained on AID and 23 were treated with IV insulin or MDI during labor and delivery; 19 were managed with insulin infusion and four remained on MDI. There was no difference in mean glucose or time in hypoglycemia between groups during the intrapartum or postpartum period. There was no difference in TIR intrapartum, but TIR 48 hours post-partum was higher in those managed with AID (Table). Conclusion: This study demonstrates that continuing AID systems during labor and in the immediate postpartum period is as safe and efficacious as switching to IV insulin infusion and MDI treatment, suggesting that it should be standard practice to allow women the option of continuing AID during labor and delivery. Disclosure E.L. Huppert: None. Y. Chen: None. L. Peng: None. N. Zork: None. G. Umpierrez: Research Support; Current; Abbott, Dexcom, Inc., Bayer AG. Advisory Panel; Ended; Sanofi-Aventis U.S., Dexcom, Inc. Other - Education grant; Current; Lilly Diabetes, Abbott Diabetes. Advisory Panel; Current; Glycare, Glucotrack. Research Support; Current; Corcept Therapeutics. M.M. Bogun: Consultant; Current; AstraZeneca, Lilly. Research Support; Ended; Dexcom, Inc.