Diabetes technology has been steadily evolving for more than 40 years with regard to both insulin delivery and glucose monitoring. This has led to benefits with both control of glycaemia as well as improving quality of life and reducing the burden of living with diabetes.
Insulin pump therapy enables many with type 1 diabetes to achieve better glycaemic control, have reduced glycaemic excursions and better quality of life. It is not the preferred mode of insulin delivery for all though and requires appropriate training and active engagement of the person with diabetes for both optimal and safe usage. In addition it is not affordable for many. It also carries risk for ketoacidosis. It has not clearly been shown to lead to better pregnancy outcomes though there have been no randomised controlled studies in pregnancy comparing insulin pump therapy with multiple daily injections.
Continuous glucose monitoring (CGM) in conjunction with fingerprick glucose testing has been shown in the CONCEPTT study to lead to better pregnancy outcomes compared to fingerprick testing alone. This has led to the Commonwealth Government providing fully subsidised access to CGM for women with type 1 diabetes starting pre-pregnancy and continuing till 3 months after due delivery date.
All forms of diabetes technology require appropriate patient education and support. Diabetes technology is very time demanding for diabetes health professionals. This is particularly so during pregnancy when there is no ‘steady state’ period and contact /review is required mostly weekly for assessment and decisions on glycaemic management.