Last updated July 12, 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
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
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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.
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.
Limited generalizability due to specific population studied Potential confounding factors not fully controlled Small sample size may affect the robustness of findings
Published in
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
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
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This study contributes evidence to Insulin pump, Multiple Daily Injections (MDI) and Emergency cesarean section rate, HbA1c, Mean sensor glucose, and 1 more.
This study contributes evidence to
Primary intervention
Insulin pump
Primary outcomes
Evidence topics
Primary intervention
Primary outcomes
Intervention and outcome relationships this study adds to the evidence network.
Editorial context
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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.
2
Related topics
8
Evidence pairs
555
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Evidence topic
Contributes evidence
Evidence topic
Contributes evidence
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Primary evidence
Evidence relationship
Related evidence
Evidence relationship
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Evidence topic
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Core evidence
The primary outcomes reported in this study.
Insulin pump → Emergency cesarean section rate
Insulin pump → Emergency cesarean section rate
Insulin pump → Rate of preterm delivery (<37 weeks)
Insulin pump → Rate of preterm delivery (<37 weeks)
Multiple Daily Injections (MDI) → Emergency cesarean section rate
Multiple Daily Injections (MDI) → Emergency cesarean section rate
Multiple Daily Injections (MDI) → Mean sensor glucose
Multiple Daily Injections (MDI) → Mean sensor glucose
Multiple Daily Injections (MDI) → Rate of preterm delivery (<37 weeks)
Multiple Daily Injections (MDI) → Rate of preterm delivery (<37 weeks)
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Relationships organized using the Dediabetes Evidence Intelligence™ framework.
This study contributes to evidence on Insulin Delivery Systems and Emergency cesarean section rate, Insulin Delivery Systems and HbA1c.
This study contributes to the evidence on the following intervention-outcome relationships.
Devices & Technology
Devices & Technology
Curated evidence collections and hubs this study is part of.
All studies measuring Emergency cesarean section rate
Measures Emergency cesarean section rate as a key outcome.
All studies measuring HbA1c
Measures HbA1c as a key outcome.
All studies on Insulin Delivery Systems
Contributes to Insulin Delivery Systems evidence base.
Latest published studies
Published within the last 2 years.
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1 results
1 results
1 results
1 results
1 results
Generated from the study's connected evidence using Evidence Intelligence™.
Insulin Delivery Systems appears to improve HbA1c.
ConsistencyScore™: Results are consistent across studies.
Ranked evidence signals
HbA1c
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on 12 supporting studies with consistent results and a positive effect signal.
Limitations
Insulin Delivery Systems may improve Mean Glucose Levels.
ConsistencyScore™: Results are generally consistent across studies.
Ranked evidence signals
Mean sensor glucose
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on 6 supporting studies with generally consistent results and a positive effect signal.
Limitations
Current evidence does not show a clear benefit of Multiple Daily Injections (MDI) for HbA1c.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
HbA1c
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
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
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
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