What does this research mean for the field?

Closed-loop insulin delivery systems significantly improve the pregnancy experience for women with type 1 diabetes by enhancing control and autonomy, though comprehensive support from healthcare providers remains essential to mitigate the isolating burden of disease management. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This research explores the experiences of pregnant women with type 1 diabetes using closed-loop insulin delivery during the CIRCUIT trial.

June 13, 2026

A qualitative enquiry into the lived experiences of women with type 1 diabetes using closed‐loop insulin delivery in pregnancy in the CIRCUIT trial

Key Points

This research explores the experiences of pregnant women with type 1 diabetes using closed-loop insulin delivery during the CIRCUIT trial.
Conducted semi-structured interviews with 18 participants from the CIRCUIT trial.
Employed inductive thematic analysis on transcripts to identify major themes.
Identified four key themes: independence and isolation, the significance of support, impacts of closed-loop technology, and the need for control and autonomy.
Participants noted that closed-loop systems significantly improved diabetes management and emotional well-being during pregnancy.
Lack of knowledge about type 1 diabetes among personal networks and intrapartum care providers posed challenges for maintaining autonomy.

Abstract

Abstract Aims This qualitative inquiry aimed to explore the lived experiences of pregnant women with self‐management of type 1 diabetes (T1D) using closed‐loop insulin delivery in the CIRCUIT trial 9 to provide a qualitative overview of its impacts and improve the understanding of T1D experiences in pregnancy. Methods We used semi‐structured, individual interviews with 18 CIRCUIT randomized trial participants. Two team members analysed verbatim transcripts using inductive thematic analysis. Results Four major themes emerged: 1. Independence and isolation; 2. Support is key; 3. Closed‐loop impacts; and 4. Control and autonomy. Diabetes management during pregnancy was an emotionally overwhelming experience that was managed largely independently. Closed‐loop was noted as a gamechanger for diabetes management during and after pregnancy. Participants felt the transition to and use of this technology would not have been possible without their healthcare team's support. Permeating all themes was the importance of control to achieve the best possible glycaemic outcomes for the health of their babies and autonomy over personal treatment decisions. The perceptions of loss of personal autonomy were associated with high anxiety. Conclusions Managing T1D while pregnant is an independent and isolating endeavour, due to the ‘invisible labour’ involved and the lack of knowledge about T1D management in personal networks. Support from partners and care providers alleviated stress. Experiences with intrapartum care providers who had limited T1D understanding were perceived as a challenge by some for maintaining autonomy. The closed‐loop system was seen as a ‘gamechanger’ in T1D pregnancy management, with unanimous perception of positive impacts that far outweigh any challenges. Use of this closed‐loop system has potential to vastly improve pregnancy experiences among those with T1D.

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