2888-LB: Real-World Multicenter Experience Using Advanced Hybrid Closed-Loop Systems in Pregnancies Complicated by Type 1 Diabetes

Introduction and Objective: Pregnancy complicated by type 1 diabetes carries maternal and neonatal risks associated with hyperglycemia. We aimed to evaluate the impact of Advanced Hybrid Closed-Loop Systems (AHCLS) on glycemic control, outcomes and admissions during pregnancy compared with Multiple Daily Insulin Injections with Continuous Glucose Monitors (MDI+CGM). Methods: This was a multicenter retrospective study conducted between January 2020 and December 2025. Data included demographics, clinical history, maternal and neonatal complications, and pump-derived glycemic metrics: Time-in-Range (TIR), Time-Below-Range (TBR) and Time-Above-Range (TAR). Results: 96 subjects were included with equal distribution and no significant demographic or disease-related differences. In the AHCLS group, 17 (35.4%) were using AHCLS before conception. While 19 (39.6%), 10 (20.8%) and 2 (4.2%) installed it in the 1st, 2nd and 3rd trimester, respectively. Glycemic control data are summarized in Figure 1. 10 (20.8%) and 25 (52.1%) of the AHCLS and MDI+CGM groups needed admission during pregnancy (P = 0.003). No differences were found in outcomes, modes of delivery, maternal or neonatal complications. Conclusion: AHCLS were associated with improvement in TIR, TAR and TBR with less overall need for admissions. Particularly for diabetes-related concerns. Disclosure A.A. Alnomi: None. M. Almehthel: Other - Advisory panel, speakers, research support; Current; Abbott, Novo Nordisk, Sanofi. Other - advisor and speaker; Ended; Insulet Corporation. Other - advisor and speaker; Current; Amgen Inc. Advisory Panel; Ended; Vertex Pharmaceuticals Incorporated. Other - adviser and speaker; Current; AstraZeneca. Speaker's Bureau; Ended; Lilly, Novartis Pharmaceuticals Corporation. Other - advisor, speaker and research support; Current; Dexcom, Inc. B. Bohlega: None. A. Aljohani: None. I. Alghofaili: None. J. Alatawi: None.