Exploring the Potential of the CamAPS FX Advanced Hybrid Closed-Loop (AHCL) System in the Hospital Setting: From Pregnancy to a Postpartum Complicated by Infective Endocarditis of the Tricuspid Valve

Managing glycemic control in type 1 diabetes during pregnancy is still very complex and extremely important to reduce maternal and fetal risks. We present the case of a 36-year-old woman with type 1 diabetes mellitus managed throughout her pregnancy with an advanced hybrid closed-loop (AHCL) CamAPS FX. Glycemic control during pregnancy was optimal, with a time in range (64-140 mg/dL) in the second and third trimesters > 75%. No serious episodes of hypoglycemia or ketoacidosis occurred. A vaginal delivery occurred at the 39th week, with a favorable neonatal outcome (birth weight 3,418 g, Apgar score 8/9). The uniqueness of this clinical case is related to the fact that the patient experienced several postpartum complications: hospitalization for tricuspid valve endocarditis, which initially manifested with pulmonary embolism. The postpartum period, characterized by breastfeeding, changes in sleep-wake rhythm, newborn care, infectious disease, antibiotics, and hospitalization, was managed by the algorithm. The insulin pump was never interrupted and continued with the support of the diabetes team, achieving optimal glycemic control throughout the postpartum period until the acute condition resolved with a time in range (70-180 mg/dL) of 88%. The CamAPS system in our case has therefore proven to be effective, safe, and adaptable during pregnancy, the postpartum period, and hospitalization during the acute phase of the disease.