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New technology ‘game changing’ for pregnant women with diabetes

Study shows automated insulin delivery could help pregnant women better manager their blood sugars compared to traditional therapy

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Automated insulin delivery should be rolled out to pregnant women with type 1 diabetes, researchers at the University of East Anglia have said.

A new study published today shows that the move could help pregnant women better manager their blood sugars compared to traditional insulin pumps or multiple daily injections.

Automated insulin delivery, also known as hybrid closed-loop technology, gives insulin doses as informed by a smartphone algorithm. It works by taking readings from a continuous glucose monitor and uses an algorithm to tell an insulin pump how much insulin to deliver.

The system adjusts insulin doses every 10-12 minutes according to blood sugar levels, meaning that it continuously responds to the persistent changes in blood sugar levels throughout pregnancy, reducing the number of decisions a patient has to make every day.

Researchers at University of East Anglia trialled the hybrid closed-loop technology and compared it with the traditional continuous glucose monitoring and insulin systems, where women supported by specialist diabetes maternity teams, make multiple daily decisions about insulin doses.

The study involved 124 pregnant women with type 1 diabetes aged 18-45 years who managed their condition with daily insulin therapy. Half were randomly allocated to use the hybrid closed-loop technology, and half to use the traditional insulin therapy.

On average, pregnant women used the hybrid closed-loop technology for more 95 per cent of the time.

“Despite better systems for monitoring blood sugars and delivering insulin, altered eating behaviours and hormonal changes during pregnancy, mean that most women struggle to reach the recommended blood sugar targets,” said lead researcher, Professor Helen Murphy, from UEA’s Norwich Medical School.

“This means that complications related to having type 1 diabetes during pregnancy are widespread, affecting one in every two new-born babies.

“For the baby, these include premature birth, need for intensive care after birth, and being too large at birth, which increases the lifelong risk of overweight and obesity. Low blood sugars, excess weight gain, and high blood pressure during pregnancy are common amongst mothers.”

“We wanted to investigate how automated insulin delivery could help” she added.

“We found that the technology helped to substantially reduce maternal blood sugars throughout pregnancy. Compared to traditional insulin therapy methods, women who used the technology spent more time in the target range for pregnancy blood sugar levels – 68 per cent vs 56 per cent, which is equivalent to an additional two-and-a-half to three hours every day throughout pregnancy.

“It was safely initiated during the first trimester, which is a crucially important time for babies’ development. The blood sugar levels improved consistently in mothers across of all ages, and regardless of their previous blood sugar levels or previous insulin therapy.”

The team also found that women using the technology gained less weight and were less likely to have blood pressure complications during pregnancy.

Importantly, women using the technology also had fewer antenatal clinic appointments, and fewer out-of-hours calls with maternity clinic teams, suggesting that this technology could also be time-saving for pregnant women and maternity services.

“For a long time, there has been limited progress in improving blood sugars for women with type 1 diabetes, so we’re really excited that our study offers a new option to help pregnant women manage their diabetes,” said Murphy.

“We know that for women with type 1 diabetes, unborn babies are exquisitely sensitive to small rises in blood sugars, so keeping blood sugar levels within the normal range during pregnancy is crucial to reduce risks for the mother and child.

“Previous studies have confirmed that every extra hour spent in the blood sugar target range reduces the risks of premature birth, being too large at birth and need for admission to neonatal intensive care unit.”

Researchers noted some limitations, including that the current study was too small for a detailed examination of baby health outcomes, and that their results are specific to the CamAPS technology.

This, the team said, means the results can’t be extrapolated to closed-loop systems, with higher blood sugar targets, that may not be applicable for use during pregnancy.

Pregnancy

Scotland to publish dedicated miscarriage patient charter

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Scotland is set to publish the UK’s first dedicated miscarriage patient charter, giving women and families clear information on NHS care and support.

Commissioned by the Scottish Government and developed with baby-loss charities Tommy’s, Held In Our Hearts and the Miscarriage Association, the charter sets out minimum standards for compassionate, clinically appropriate and culturally competent miscarriage care across Scotland.

It builds on the Scottish Government’s Delivery Framework for Miscarriage Care, which has already changed practice across NHS boards.

Jenni Minto, Scottish public health and women’s health minister, said: “Miscarriage is devastating, and for too long women have not had the care and support they deserve.

“That is changing. Scotland will become the first country in the UK to publish a miscarriage patient charter, meaning women know exactly how they will be supported by health services following their loss.”

Unlike previous UK-wide norms, where women were typically offered enhanced support only after three miscarriages, Scotland’s approach means women can receive appropriate support after their first miscarriage.

The charter also sets out clear rights and expectations so every woman, regardless of location or circumstance, understands the care she should receive.

It includes access to private rooms in hospitals rather than busy clinical areas or maternity settings, progesterone treatment where clinically appropriate, compassionate and culturally competent bereavement support, and clear information in 18 languages, including British Sign Language and audio formats.

Progesterone is a hormone that growing evidence suggests may help reduce the risk of miscarriage in certain cases when given to women who meet specific clinical criteria.

The Scottish Government said the charter is designed to ensure personalised, respectful care and to address long-standing inequalities experienced by women during miscarriage.

It is intended to provide clarity on the support women can expect, consistent standards across all NHS boards, stronger awareness and confidence among healthcare professionals, and better access to emotional and practical support services.

Charities involved in its development said many women still report feeling dismissed, uninformed or unsupported during miscarriage.

They said the new charter marks an important step towards making sure every woman feels heard, respected and cared for.

The charter aligns with Scotland’s wider Women’s Health Plan, which is improving care across reproductive, menstrual, maternal and perinatal health.

Recent national developments include greater investment in women’s health services, improved training for healthcare staff, new digital and in-person support tools, and targeted action to reduce inequalities in access and outcomes.

Together, these measures aim to create a more compassionate and equitable women’s health system.

Minto said: “This charter is a landmark moment.

“It tells women clearly what they should expect from their NHS, and it holds services to account for delivering it.

“Scotland is leading the way, and I am proud of the progress NHS boards and our charity partners have made together.”

The model is expected to inform wider UK discussions on miscarriage support, bereavement care and early pregnancy services.

The charter will be made publicly available, offering women, partners and families clear guidance on their rights and the standards they can expect when seeking care.

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Physical activity may reduce hypertension risk in pregnancy

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More light activity and less sitting in pregnancy may cut the risk of high blood pressure conditions by nearly 30 per cent, early research suggests.

The study looked at nearly 500 pregnant women at three healthcare centres in the US and found that time spent sitting and doing light physical activity were the strongest predictors of hypertensive disorders of pregnancy.

Hypertensive disorders of pregnancy include gestational hypertension and preeclampsia, a serious condition involving high blood pressure that can damage organs.

Women who limited sedentary time to about eight hours a day and did at least seven hours of light physical activity, alongside an average of 22 minutes of higher-intensity activity and nine hours of sleep, had a 30 per cent lower risk of developing these conditions.

The findings were presented at the American Heart Association’s EPI|Lifestyle Scientific Sessions 2026 in Boston and are considered preliminary.

The study, led by researchers at the University of Iowa, included 470 women aged 18 to 45 who were enrolled between 2021 and 2024 at healthcare centres in Iowa, Pennsylvania and West Virginia.

Participants wore two monitors for 24 hours over seven consecutive days during each trimester to measure sedentary behaviour, sleep and activity patterns.

Of the participants, 18.6 per cent developed hypertensive disorders of pregnancy. The lowest-risk daily pattern was linked to an 8 per cent chance of developing these conditions, compared with 16.9 per cent among those with a typical daily pattern.

The risk was higher among those who sat for more than 10 hours a day or did less than five hours of light activity daily.

Lead study author Kara Whitaker, associate professor in the department of health, sport and human physiology at the University of Iowa, said: “Our study suggests that in the real world, where daily routines vary widely, it may actually be the balance of sitting time and light intensity movement across the entire day that matters most.”

“This doesn’t mean exercise isn’t beneficial, rather, that when it comes to hypertensive disorders of pregnancy, everyday movement and limiting long periods of sitting may play a bigger role than we previously understood.”

She added: “These findings have the potential to shift how we think about physical activity and sleep during pregnancy. Right now, there are no clear, quantitative guidelines for how much sitting or light intensity movement is healthiest during pregnancy, and our results provide early evidence that could help shape those recommendations in the future. Ultimately, this line of research could give patients and clinicians more practical, achievable ways to support healthier pregnancies.”

Natalie A. Bello, associate professor of cardiology at the Smidt Heart Institute at Cedars-Sinai Medical Center, who was not involved in the study, said: “The researchers extend this to the pregnant population where nearly 20 per cent of participants developed a hypertensive disorder of pregnancy. They saw incremental associations between more physical activity and lower risk of developing preeclampsia or gestational hypertension. It remains to be seen whether this association is causal, and future studies designed to increase physical activity and reduce sedentary behaviour in pregnancy are needed.”

High blood pressure develops in up to 5 to 10 per cent of all pregnancies and is a leading cause of foetal and maternal disease and death.

The study had several limitations, including that 83 per cent of participants self-reported as non-Hispanic white and tended to have higher education and income levels, meaning the findings may not reflect the experiences of other population groups.

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Experts call for better type 2 diabetes care for pregnant women

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Experts are calling for urgent action to improve type 2 diabetes care for women with early-onset disease before, during and after pregnancy.

A new consensus statement from clinicians and researchers across the UK and Ireland sets out critical gaps in current knowledge and priorities for future research to better support women and their babies.

Type 2 diabetes in women of reproductive age is rising, yet evidence to guide safe and effective care across pregnancy remains limited, the group said.

Being diagnosed at a young age increases the risk of serious problems during pregnancy, as well as long-term health problems for both mothers and their babies.

Dr Sara White, clinical senior lecturer in women’s health and diabetes at King’s College London, said: “Type 2 diabetes in women of reproductive age is rising, yet evidence to guide safe and effective care across pregnancy is limited.

“From the experience of clinicians and women living with diabetes, we know that being diagnosed with type 2 diabetes at a young age increases the risk of serious problems during pregnancy, as well as long-term health problems for both mothers and their babies.

“Even so, most research has focused on managing blood sugar during pregnancy. Much less attention has been given to helping women prepare before pregnancy, supporting them after birth, and understanding the wider social factors that affect health outcomes.

The consensus statement brings together evidence from three large systematic reviews, alongside expert and audience discussion from the Diabetes UK Annual Professional Conference in 2025.

It highlights an urgent need to rethink how care is designed and delivered for this group of women.

Professor Claire Meek, professor of chemical pathology and diabetes in pregnancy at the University of Leicester, said the lack of evidence leaves both women and clinicians navigating pregnancy with too little support.

She said: “Women with early-onset type 2 diabetes are often managing complex health needs at a young age, yet the systems around them are not designed with that reality in mind.

“We need coordinated, evidence-based care that starts before pregnancy, continues after birth, and recognises the wider social and cultural barriers many women face.”

The group identifies several priority areas where research and service change could make an immediate difference.

These include improving access to preconception care, supporting healthy weight before, during and after pregnancy, and strengthening postnatal follow-up to reduce long-term risks such as cardiovascular disease.

The statement also stresses the importance of addressing inequalities linked to deprivation, ethnicity, language barriers and access to healthcare.

The researchers said women’s experiences must sit at the heart of future work.

Many women report feeling judged or stigmatised, poorly informed about pregnancy risks, and unsupported once specialist maternity care ends.

Dr Rita Forde, senior lecturer at the School of Nursing and Midwifery, University College Cork, said: “By setting out a shared research agenda we hope to accelerate studies co-developed with women and communities that will improve outcomes for these women and their future children.”

The consensus statement calls on funders, policymakers and healthcare leaders to act now, warning that without targeted investment, preventable harms to women and babies will continue to rise alongside the growing prevalence of early-onset type 2 diabetes.

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