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Poster Session 2

Category: Diabetes

Poster Session 2

(425) Glycemic Control and Pregnancy Outcomes among Individuals using Hybrid Closed-Loop Therapy

Wednesday, February 11, 2026

3:30 PM - 5:00 PM

Submitting Author and Presenting Author(s)

Annabeth Brewton, MD

Fellow
The Ohio State University Wexner Medical Center
Columbus, Ohio, United States

Coauthor(s)

RP

Radhika A. Pandit, MD

Resident physician
The Ohio State University Department of Obstetrics and Gynecology
Columbus, Ohio, United States
JW

Jiqiang Wu, MSc

The Ohio State University Wexner Medical Center
Columbus, Ohio, United States
NS

Natasha Santhanam, BA

Medical Student
The Ohio State University College of Medicine
Columbus, Ohio, United States
EP

Ellena Privitera, BS

Medical Student
The Ohio State University College of Medicine
Columbus, Ohio, United States
SV

Shaylyn Vickers, FNP, MSN

Nurse Practitioner
The Ohio State University Wexner Medical Center
Columbus, Ohio, United States
SG

Steven Gabbe, MD (he/him/his)

The Ohio State University Wexner Medical Center
Columbus, Ohio, United States
WG

William A. Grobman, MBA, MD

Professor
Warren Alpert Medical School of Brown University
Providence, Rhode Island, United States
Mark B. Landon, MD

Richard L. Meiling Professor and Chair, Obstetrics and Gynecology
The Ohio State University Wexner Medical Center
The Ohio State University Wexner Medical Center, Ohio, United States
Christine P. Field, MD, MPH (she/her/hers)

Maternal Fetal Medicine Physician, Assistant Professor
The Ohio State University Wexner Medical Center
The Ohio State University Wexner Medical Center, Ohio, United States
Elizabeth O. Buschur, MD (she/her/hers)

Associate Professor
The Ohio State University Wexner Medical Center
Columbus, Ohio, United States
Kartik K. Venkatesh, MD, PhD (he/him/his)

Associate Professor
The Ohio State University Wexner Medical Center
The Ohio State University Wexner Medical Center, Ohio, United States

Objective:
Pregnant individuals with type 1 diabetes (T1D) increasingly utilize hybrid closed-loop (HCL) therapy with continuous glucose monitoring (CGM), which offers two modes for insulin delivery: automated (HCL) and manual (sensor augmented pump therapy, [SAPT]). While international data demonstrate pregnancy-specific automated HCL is associated with improved glycemic control, such pregnancy-specific algorithms are not available in the US. Hence, individuals with T1D may use manual SAPT or automated HCL with off-label use in pregnancy. We compared glycemic management and pregnancy outcomes between those using automated HCL versus manual SAPT.

Study Design:
A retrospective analysis of pregnant individuals with T1D using HCL enrolled in an integrated prenatal and diabetes care program from 2022-2024. The exposure was intent to use automated HCL (using non-pregnancy algorithms) versus manual SAPT (reference) at prenatal care initiation. Outcomes included glycemic control (A1c, CGM metrics) and pregnancy outcomes (cesarean delivery, HDP, PTB, LGA, NICU admission, hypoglycemia, hyperbilirubinemia, and RDS). An Inverse-Probability-of-Treatment Weighting analytic approach was used to address confounding by insulin pump type, duration of T1D, and early pregnancy A1c.

Results:
Among 138 pregnant individuals with T1D using HCL, 67% (n=93) used automated mode and 32.6% (n=45) used manual SAPT (median gestational age: 8 weeks). Individuals with automated HCL were more likely to have an Omnipod or Tandem pump and have a lower early pregnancy A1c, and had less time below range compared with those in manual mode (p<0.10) (Table 1). In unadjusted analyses, individuals using automated HCL were less likely to have a cesarean delivery, PTB, and time below range compared with those using manual SAPT. Following adjustment, glycemic control and pregnancy outcomes did not differ between groups.

Conclusion:
Glycemic control and pregnancy outcomes were similar for those using automated HCL and manual SAPT. Whether outcomes can be further optimized with pregnancy-specific HCL algorithms in the US is a research priority.