Automated insulin delivery during the first 6 months postpartum (AiDAPT): a prespecified extension study.

Summary

This prespecified extension of a multicenter RCT followed 57 women with type 1 diabetes for 6 months postpartum. Hybrid closed-loop automated insulin delivery maintained approximately 70% time-in-range compared with standard therapy plus CGM, supporting continued postpartum use.

Key Findings

• In the postpartum extension (n=57), the HCL group maintained approximately 70% time-in-range over 6 months.
• Randomized allocation from the original trial was preserved, comparing HCL vs standard insulin therapy with CGM.
• Primary endpoint assessed TIR at 0–3 months, 3–6 months, and cumulatively over 6 months postpartum.

Clinical Implications

Postpartum individuals with type 1 diabetes who used HCL during pregnancy can safely continue hybrid closed-loop therapy to sustain near-target glycemia during the first 6 months after delivery.

Limitations

• Modest postpartum sample size (n=57) with eligibility constraints may limit generalizability.
• Abstract does not report detailed secondary outcomes (e.g., hypoglycemia, patient-reported outcomes).

Future Directions

Assess maternal-infant outcomes, lactation-related factors, hypoglycemia burden, usability, and cost-effectiveness of postpartum hybrid closed-loop use in larger and more diverse populations.