ABSTRACT
This chapter explores women on pump therapy started with lower prepregnancy HbA1cs and were more likely to have had preconception care. Women treated with pump therapy were more likely to have large-for-gestational-age infants with a trend toward a higher frequency of neonatal hypoglycemia but no difference in other neonatal outcomes. However, women with type 1 diabetes face a number of challenges in achieving and maintaining tight glycemic control during pregnancy. Hormonal and other factors mean that insulin requirements change with advancing gestation and can be difficult to accurately predict. It is widely accepted that in order to reduce the fetal impacts of maternal diabetes, periods of hyperglycemia should be minimized. Fuzzy logic models recognize that the same dose of insulin may not always cause the same change in glucose level. Closed-loop insulin delivery systems have the potential to revolutionize the treatment of type 1 diabetes, resulting in stable glycemic control with minimal patient intervention.
