Practical Approach to Continuous Glucose Monitoring Interpretation and Automated Insulin Delivery Use in Pregnancy: Considerations for Obstetric Providers
Bibliographic record
Abstract
While automated insulin delivery (AID) systems have multiple well-established benefits outside of pregnancy and are widely used in non-pregnant individuals with type 1 diabetes (T1D), none of the commercially available AID systems in North America are approved for use during pregnancy. Use of commercially available AID systems off-label in pregnancy is currently limited by: (1) glucose targets higher than the fasting glucose target range recommended during pregnancy and (2) algorithms which were not designed for the dynamic changes in insulin resistance which occur across gestation. However, as AID use in the general population expands, many individuals will opt to continue using these systems off-label during pregnancy, and thus, guidance for providers regarding AID use and optimization during pregnancy is of the utmost importance. A cornerstone to the effective use of AID systems is the systematic and accurate interpretation of continuous glucose monitoring (CGM) data. One obstacle to the use of both CGM and AID systems by obstetric providers is the lack of comfort with CGM interpretation. We therefore present here: (1) a systematic approach to CGM interpretation during pregnancy and (2) practical guidance regarding AID use during pregnancy for individuals who opt to use commercially available AID systems off-label during pregnancy after consideration of individualized risks and benefits.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".