New Consensus Sets Global Standards for Diabetes Technology in Pregnancy
In a landmark move, the diaTribe Foundation released the first international consensus statement focused on the use of continuous glucose monitoring (CGM) and automated insulin delivery (AID) during pregnancy. The guidance is designed to help clinicians, pregnant people with diabetes, and their care teams navigate the rapidly evolving landscape of diabetes technology with safety, effectiveness, and equity in mind.
Why This Consensus Matters
Diabetes management during pregnancy presents complex challenges. CGM and AID technology have transformed glucose data access and insulin dosing for many patients, but the variability in practices across countries and healthcare systems has limited consistent care. The international consensus aims to harmonize recommendations, reduce variability, and improve maternal and fetal outcomes by outlining best practices for technology use, safety monitoring, and patient education.
Key Recommendations for CGM Use During Pregnancy
The consensus emphasizes early integration of CGM in prenatal care for people with type 1, type 2, or gestational diabetes who require close glucose monitoring. Key points include:
- Routine CGM initiation at the earliest feasible gestational age to guide insulin adjustments.
- Regular data review by multidisciplinary teams, with emphasis on time-in-range (TIR) targets appropriate to gestational stage and individual risk.
- Structured education for patients and caregivers on interpreting CGM metrics, alarms, and response plans to prevent hypoglycemia and hyperglycemia.
- Equitable access considerations, including strategies to minimize cost barriers and ensure diverse populations can benefit from CGM data.
CGM in Daily Management
The guidance notes that CGM can reduce the burden of frequent finger-stick testing and improve confidence in glucose management. It also highlights the importance of device compatibility with national reimbursement policies and clinical workflows to maximize consistent use across care settings.
AID Systems: When and How to Use
AID technology—automated insulin delivery—offers promising avenues for tighter glucose control during pregnancy. The consensus outlines patient selection, safety checks, and monitoring protocols, including:
- Appropriate initiation timing based on fetal and maternal health status, with gradual adaptation plans for changes during trimester transitions.
- Clear criteria for pausing or adjusting automated delivery in response to illness, surgery, or other comorbidities.
- Close collaboration with obstetric teams to align insulin dosing goals with pregnancy-specific glycemic targets and fetal well-being.
Balancing Technology and Clinical Judgment
A core theme of the consensus is that technology should augment—never replace—clinical judgment. The document encourages clinicians to tailor CGM and AID use to each patient’s physiology, pregnancy course, and personal preferences while maintaining robust safety monitoring and data-driven decision-making.
Implementation and Equity Considerations
Recognizing global disparities in access to diabetes technology, the consensus urges policymakers and healthcare providers to address affordability, device availability, and digital literacy. Educational resources, interpreter services, and culturally competent care are highlighted as essential components to ensure all pregnant people with diabetes can benefit from CGM and AID technologies.
What Comes Next
The international consensus is expected to catalyze updates to clinical guidelines worldwide, spur payer policy changes, and foster patient-centered research on technology use in pregnancy. diaTribe encourages ongoing collaboration among endocrinologists, obstetricians, nurses, and patients to refine best practices as technology evolves.
About diaTribe and the Consensus Process
The diaTribe Foundation, a nonprofit dedicated to improving diabetes care through evidence-based information, convened experts from multiple countries to synthesize current data, clinical experience, and patient perspectives. The resulting consensus aims to standardize high-quality care while accommodating local health system realities and patient needs.
