Resumen de Investigación
Analyzed using Evidence Intelligence™

Insulin pumps linked to higher preterm delivery in type 1 diabetes

Última actualización 12 de julio de 2026

Key finding

Preterm delivery was more common with insulin pumps (25.9% vs. 16.7%, P = 0.01)

This study examined pregnancy and post-delivery outcomes in women with type 1 diabetes using non-automated insulin pumps versus multiple daily injections. It found higher rates of preterm delivery and caesarean sections associated with insulin pumps.

Quick read

Study at a glance

The essential study design details in one scan.

EvidenceScore™

Moderate

Study type

RCTs

Follow-up

Medium-Term (3–12 mo)

Risk of bias

High Risk

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Plain-language summary

What this paper says

A plain-language read of the study’s main message and where it applies.

Study focus

This study examined pregnancy and post-delivery outcomes in women with type 1 diabetes using non-automated insulin pumps versus multiple daily injections. It found higher rates of preterm delivery and caesarean sections associated with insulin pumps.

Clinical relevance

The findings highlight important considerations for managing pregnancy in women with type 1 diabetes. The increased risk of preterm delivery and caesarean sections associated with insulin pumps may influence treatment decisions and counseling for expectant mothers. Understanding these risks can help healthcare providers better support women during pregnancy and improve maternal and neonatal outcomes.

Keep in mind

Limited generalizability due to specific population studied Potential confounding factors not fully controlled Small sample size may affect the robustness of findings

Published in

Referencia de la Revista

Publication details and source links for this paper.

Katrine C, Sidse KN, Kirsten N, et al. Pregnancy and post-delivery outcomes with non-automated insulin pumps or multiple daily injections in women with type 1 diabetes. Acta Diabetologica. 2025;63(1):25-35. doi:10.1007/s00592-025-02560-w

Efectos Principales

Preterm delivery was more common with insulin pumps (25.9% vs. 16.7%, P = 0.01)

Caesarean section rates were higher with insulin pumps (59% vs. 40%, P = 0.04)

No significant difference in HbA1c levels at 9 weeks (P = 0.65) or 35 weeks (P = 0.53)

Mean sensor glucose decreased similarly in both groups from 7.0 mmol/l at 9 weeks to 6.3 mmol/l at 33 weeks

Evidence network

How this study fits

Understand where this research contributes within the broader evidence network.

Evidence Context

This study contributes evidence to Insulin pump, Multiple Daily Injections (MDI) and Emergency cesarean section rate, HbA1c, Mean sensor glucose, and 1 more.

Primary intervention

Insulin pump

Primary outcomes

  • Emergency cesarean section rate
  • HbA1c
  • Mean sensor glucose

Evidence relationships

Intervention and outcome relationships this study adds to the evidence network.

8
Evidence pairs
8
Relationships
1
Evidence topics
contributes_evidence

Editorial context

Why this study matters

See why this paper is useful beyond its individual results.

Evidence network role

This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.

Moderate contributionModerate confidenceNetwork score: 63

1

Related topics

8

Evidence pairs

603

Related studies

High relevance in at least one topic

Why it is useful

  • Contributes to 8 evidence relationships
  • Includes primary outcome data
  • Linked to 1 direct semantic evidence topic

Topic contributions

Evidence topic

Contributes evidence

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Evidencia principal

Relación de evidencia

Insulin Delivery Systems and HbA1c

Evidencia relacionada

Tema de evidencia

HbA1c Reduction

Guardar evidencia

Intervención

Insulin Delivery Systems

Guardar evidencia

Core evidence

Study findings

The primary outcomes reported in this study.

Emergency cesarean section rate

Insulin pump → Emergency cesarean section rate

Insulin pump → Emergency cesarean section rate

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
25
Negative
ConsistencyScore™
unclear
Not enough independent studies
Estudios de apoyo: Basado en 1 estudio
Add to Evidence Tracker

HbA1c

Insulin pump → HbA1c

Insulin pump → HbA1c

Evidence Intelligence™
EvidenceScore™
Moderate
Score 69 · Based on 2 studies
ImpactScore™
50
Neutral
ConsistencyScore™
100
consistent
Estudios de apoyo: Basado en 2 estudios
Add to Evidence Tracker

Mean sensor glucose

Insulin pump → Mean sensor glucose

Insulin pump → Mean sensor glucose

Evidence Intelligence™
EvidenceScore™
Moderate
Score 69 · Based on 2 studies
ImpactScore™
50
Neutral
ConsistencyScore™
35
mixed
Estudios de apoyo: Basado en 2 estudios
Add to Evidence Tracker

Rate of preterm delivery (<37 weeks)

Insulin pump → Rate of preterm delivery (<37 weeks)

Insulin pump → Rate of preterm delivery (<37 weeks)

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
25
Negative
ConsistencyScore™
unclear
Not enough independent studies
Estudios de apoyo: Basado en 1 estudio
Add to Evidence Tracker

Emergency cesarean section rate

Multiple Daily Injections (MDI) → Emergency cesarean section rate

Multiple Daily Injections (MDI) → Emergency cesarean section rate

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
25
Negative
ConsistencyScore™
unclear
Not enough independent studies
Estudios de apoyo: Basado en 1 estudio
Add to Evidence Tracker

HbA1c

Multiple Daily Injections (MDI) → HbA1c

Multiple Daily Injections (MDI) → HbA1c

Evidence Intelligence™
EvidenceScore™
Moderate
Score 69 · Based on 2 studies
ImpactScore™
50
Neutral
ConsistencyScore™
100
consistent
Estudios de apoyo: Basado en 2 estudios
Add to Evidence Tracker

Mean sensor glucose

Multiple Daily Injections (MDI) → Mean sensor glucose

Multiple Daily Injections (MDI) → Mean sensor glucose

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
50
Neutral
ConsistencyScore™
unclear
Not enough independent studies
Estudios de apoyo: Basado en 1 estudio
Add to Evidence Tracker

Rate of preterm delivery (<37 weeks)

Multiple Daily Injections (MDI) → Rate of preterm delivery (<37 weeks)

Multiple Daily Injections (MDI) → Rate of preterm delivery (<37 weeks)

Evidence Intelligence™
EvidenceScore™
Emerging
Score 59 · Based on 1 study
ImpactScore™
25
Negative
ConsistencyScore™
unclear
Not enough independent studies
Estudios de apoyo: Basado en 1 estudio
Add to Evidence Tracker

Evidence Library

Build your evidence library

Save research, organize studies, and quickly find important evidence again.

evidence suggest

La Evidencia Sugiere

  • Insulin pump users had a 25.9% preterm delivery rate compared to 16.7% for MDI users.
  • 59% of insulin pump users required a caesarean section versus 40% for MDI.
  • No significant changes in HbA1c levels were observed between the two groups.
who this applies

A quién se aplica

  • Women with type 1 diabetes during pregnancy
  • Expectant mothers considering insulin management options
keep in mind

Tener en Cuenta

  • Results may not apply to all women with diabetes due to specific inclusion criteria.
  • The study focused on short-term outcomes; long-term effects remain unclear.
  • Further research is needed to explore underlying reasons for the observed differences.
between the lines

Entre Líneas

  • Limited generalizability due to specific population studied
  • Potential confounding factors not fully controlled
  • Small sample size may affect the robustness of findings

Evidence Library

Build your evidence library

Save research, organize studies, and quickly find important evidence again.

Connected Evidence

Explore related studies, evidence collections, and research questions.

Relationships organized using the Dediabetes Evidence Intelligence™ framework.

This study contributes to evidence on Insulin Delivery Systems and HbA1c, Insulin Delivery Systems and Mean sensor glucose.

Relaciones de evidencia relacionadas

Explore in Evidence Explorer

This study contributes to the evidence on the following intervention-outcome relationships.

Questions answered by this study

Generated from the study's connected evidence using Evidence Intelligence™.

Does Insulin Delivery Systems lower HbA1c?

Strong Evidence

Insulin Delivery Systems appears to lower HbA1c.

ConsistencyScore™: Results are consistent across studies.

Ranked evidence signals

  1. 1

    HbA1c

    EvidenceScore™ Moderate | EvidenceScore™ 69.0 | neutral | ConsistencyScore™ Consistent | 1 study

Why this answer: This answer is based on 21 supporting studies with consistent results and a positive effect signal.

21 supporting studies

Does Multiple Daily Injections (MDI) lower HbA1c?

Moderate Evidence

Current evidence does not show a clear benefit of Multiple Daily Injections (MDI) for HbA1c.

ConsistencyScore™: Results are consistent across studies.

Ranked evidence signals

  1. 1

    HbA1c

    EvidenceScore™ Moderate | EvidenceScore™ 69.0 | neutral | ConsistencyScore™ Consistent | 1 study

Why this answer: This answer is based on a single supporting study.

Limitations

  • Only one supporting study is available.
1 supporting study

Does Insulin pump improve mean sensor glucose?

Moderate Evidence

Current evidence does not show a clear benefit of Insulin pump for mean sensor glucose.

ConsistencyScore™: Results are mixed and should be interpreted cautiously.

Evidence caveat: The available evidence reports mixed findings.

Ranked evidence signals

  1. 1

    Mean sensor glucose

    EvidenceScore™ Moderate | EvidenceScore™ 69.0 | neutral | ConsistencyScore™ Mixed | 1 study

Why this answer: This answer is cautious because the available studies report mixed findings.

Limitations

  • Only one supporting study is available.
1 supporting study

Does Multiple Daily Injections (MDI) improve mean sensor glucose?

Emerging Evidence

Current evidence does not show a clear benefit of Multiple Daily Injections (MDI) for mean sensor glucose.

ConsistencyScore™: Consistency cannot yet be determined from the available evidence.

Ranked evidence signals

  1. 1

    Mean sensor glucose

    EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study

Why this answer: This answer is based on a single supporting study.

Limitations

  • Only one supporting study is available.
1 supporting study
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