Smart Insulin Pen in Pregnant Women with Type 1 Diabetes: An Encouraging Case Series.

The management of type 1 diabetes in pregnancy with new technologies is challenging. Sometimes the complexity of new-generation systems such as "continuous subcutaneous insulin infusion, CSII" and patient or provider preference do not allow their use, so women with type 1 diabetes in pregnancy continue to be treated with subcutaneous multiple-injection insulin therapy using pens. Smart insulin pens are new tools that allow for data collection on insulin dose and time of administration and have additional connectivity features. To retrospectively describe the use of a smart insulin pen coupled with rt-CGM (InPen system) in three pregnancies complicated by type 1 diabetes. Participants used the InPen system in pregnancy and consented to analysis of glycaemic data and pregnancy outcome. An increase in pregnancy specific time-in-range glucose was observed in the three patients related to the duration of insulin action, insulin sensitivity factors, and a pre-set target glucose range for pregnancy. No diabetic ketoacidosis or severe hypoglycaemia occurred. We describe practical considerations in three pregnant patients with type 1 diabetes where the InPen system was used with suggestive improvements in the time-in-range.