Belgium Consensus: CGM & Insulin Tech for Pregnant Diabetics

A study from Belgium — led by researchers at the Department of Endocrinology, University Hospitals Leuven — has produced a landmark international consensus statement on the use of continuous glucose monitoring (CGM) and automated insulin delivery (AID) systems in pregnant women with Type 1, Type 2, or gestational diabetes. Endorsed by 24 global medical societies, this guidance carries significant weight for American women managing diabetes during pregnancy.

What the Research Found

Pregnancy naturally triggers increased insulin resistance after the first trimester, creating serious blood sugar management challenges for women with pre-existing diabetes. For those without prior diabetes, this same insulin resistance can trigger gestational diabetes (GDM). While more than 95% of women with diabetes deliver healthy babies, uncontrolled blood sugar during pregnancy — called maternal dysglycaemia — raises the risk of complications for both mother and child, spanning prenatal, perinatal, and long-term postnatal outcomes.

The Belgian-led research team reviewed compelling evidence that CGM technology meaningfully reduces pregnancy complications in women with Type 1 diabetes. The consensus also supports the use of AID systems — sometimes called "closed-loop" or artificial pancreas systems — throughout preconception, pregnancy, delivery, and the postpartum period for women with Type 1 diabetes.

Blood Sugar Targets: What the Numbers Mean for You

Current US guidelines from the American Diabetes Association (ADA) recommend pregnant women with Type 1 diabetes aim for a fasting blood glucose of 70–95 mg/dL (3.9–5.3 mmol/L) and post-meal peaks below 140 mg/dL (7.8 mmol/L) at one hour. The international consensus aligns with keeping blood sugar within tightly managed ranges using CGM technology, which provides real-time readings — far more detail than traditional fingerstick testing alone.

Notably, the consensus acknowledges that ideal CGM glucose thresholds for diagnosing gestational diabetes and specific time-in-range (TIR) targets for managing GDM and Type 2 diabetes during pregnancy still need further research and standardization — an important gap that ongoing trials aim to fill.

Why This Matters for US Patients

In the United States, approximately 1 in 10 pregnancies is affected by gestational diabetes, and thousands more women with Type 1 or Type 2 diabetes navigate pregnancy each year. Despite this, access to CGM and AID technology during pregnancy has been inconsistent, and insurance coverage remains a barrier for many American patients.

This international consensus — backed by 24 global societies — provides powerful evidence that American healthcare providers and insurers should prioritize CGM access for all pregnant women with Type 1 diabetes, and strongly consider AID systems as a standard of care. For US patients, this research reinforces the conversation to have with your endocrinologist or maternal-fetal medicine specialist about upgrading your diabetes technology before or during pregnancy.

For women with gestational diabetes or Type 2 diabetes, the consensus signals that clearer CGM-based diagnostic and treatment standards are on the horizon — something American patients and providers should watch closely.

The Bottom Line

This Belgium-originated international consensus offers US patients with diabetes who are pregnant or planning pregnancy a strong evidence base to advocate for better technology access. Talk to your care team about whether CGM or an AID system is right for your pregnancy journey.

Source: Benhalima, Durnwald, Sweeting et al. "Application of continuous glucose monitoring and automated insulin delivery technologies for pregnant women with type 1, type 2, or gestational diabetes: an international consensus statement." The Lancet Diabetes & Endocrinology (2026). DOI: 10.1016/S2213-8587(25)00335-3. PMID: 41421368.