NICE has published draft guidance recommending that women with type 1 diabetes who are pregnant or planning a pregnancy should be offered a pregnancy-specific hybrid closed loop system, a move it says could improve blood sugar control and reduce risks for mothers and babies.
The device, described by NICE as a pregnancy-specific “artificial pancreas,” automatically monitors blood sugar and delivers insulin through a small pump worn on the body. NICE said the technology removes the need for frequent finger-prick tests and manual insulin injections, and that clinical trials show it can help women maintain safer blood sugar levels throughout pregnancy.
What the draft guidance says
According to the guidance, everyone planning a pregnancy should be offered a pregnancy-specific hybrid closed loop system from the point of pregnancy planning. NICE also says women should receive training and support from specialist multidisciplinary teams, and that they should be able to continue using the system during labour and birth if this has been discussed in advance and it is safe to do so.
The draft guidance further states that women can choose to continue using pregnancy-specific systems for at least six months after birth, and that clinicians should regularly revisit the option with anyone who initially declined. NICE says the system must be licensed for use in pregnancy and allow blood sugar targets within pregnancy ranges.
Why it matters for maternity care
NICE said managing blood sugar during pregnancy is difficult and critical, because levels that are too high or too low can cause serious harm to both mother and baby. The risks include miscarriage, premature birth and complications during labour.
Eric Power, interim director of the centre for guidelines at NICE, said thousands of women with type 1 diabetes give birth in England and Wales every year and that the recommendation would mean pregnancy-specific hybrid closed loop technology should be offered to all of them. Dr Marie Anne Ledingham, consultant obstetrician and consultant clinical adviser to NICE, said the technology gives clinical teams a better tool and gives patients more confidence.
Support from NHS England and diabetes groups
Marc Atkin, National Specialty Advisor for Diabetes at NHS England, said the NHS is already offering specialist technology to thousands of pregnant women living with type 1 diabetes. He said effective management of blood glucose before and during pregnancy has been shown to reduce the risk of poor maternity outcomes and minimise risk to a baby’s development.
NICE said the updated advice goes further than its 2023 recommendation on hybrid closed loop systems for women with type 1 diabetes who are pregnant or planning a pregnancy, because this is the first time it has recommended a pregnancy-specific version with features designed to manage blood sugar more tightly in pregnancy.
Diabetes UK and Breakthrough T1D both welcomed the guidance, saying the systems can reduce the day-to-day burden of diabetes management and improve outcomes for parent and baby.
NICE said the draft guidance has been published ahead of Diabetes Awareness Week.
