Why were C-section and preterm birth rates higher in pump users?

The study found these differences but could not fully explain them. They were not linked to age, diabetes duration, or complications. More research is needed to understand this finding.

Should I switch to an insulin pump if I'm planning a pregnancy?

This study suggests MDI with CGM can be equally effective. The best approach depends on your individual circumstances, so discuss your options thoroughly with your diabetes care team before and during pregnancy.

How does insulin need change during and after pregnancy with type 1 diabetes?

In pump users, basal insulin rates were about 37% higher by late pregnancy, then dropped about 20% below pre-pregnancy levels after delivery. Carbohydrate-to-insulin ratios also shifted significantly, highlighting how dynamic insulin needs are during this period.

Insulin Pumps vs. Injections in T1D Pregnancy

Key takeaways

✓Both insulin pumps and MDI achieved similar blood sugar control during pregnancy when CGM was used
✓Maternal and infant outcomes including breastfeeding were similar at 1 and 3 months post-delivery
✓Study provides reassurance that MDI is a viable and effective option during T1D pregnancy

Quick specs

Journal	Acta diabetologica
Year	2026
PMID	40759795

What This Study Looked At

Researchers examined whether using an insulin pump (versus multiple daily injections, or MDI) made a difference in pregnancy outcomes for women with type 1 diabetes (T1D). All 141 women in the study used continuous glucose monitoring (CGM) throughout their pregnancies.

Key Findings

Both groups — 39 women using non-automated insulin pumps and 102 using MDI — achieved remarkably similar blood sugar control throughout pregnancy. HbA1c levels and average sensor glucose readings were nearly identical between the two groups from early to late pregnancy.

However, there were some notable differences in delivery outcomes:

Preterm birth (before 37 weeks) was more common in pump users (26% vs. 17%)
Caesarean section rates were higher in pump users (59% vs. 40%)
These differences held even after accounting for age, diabetes duration, and complications

After Delivery

At 1 and 3 months after giving birth, outcomes for both mothers and babies — including breastfeeding rates — were similar between the two groups. Pump users required insulin dose adjustments during pregnancy (higher basal rates, adjusted carb ratios), which largely returned to pre-pregnancy levels after delivery.

What This Means for You

If you have type 1 diabetes and are pregnant or planning a pregnancy, this study suggests that with good CGM use, MDI can be just as effective as an insulin pump for blood sugar control. The higher rates of preterm birth and C-section in pump users were unexpected and warrant further investigation. Talk to your diabetes care team about which insulin delivery method is right for your individual situation.

References & Sources

Frequently asked questions

Not necessarily. This study found that women using insulin pumps and those using multiple daily injections achieved very similar blood sugar levels when both groups used continuous glucose monitors throughout pregnancy.

Editorial note

This article is for educational purposes only and does not constitute medical advice. Always consult your healthcare provider before making changes to your diabetes management. Last reviewed: July 16, 2026 by the MDS Diabetes editorial team.

What to do next

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Insulin Pumps vs. Injections in T1D Pregnancy Outcomes