Evidence map›Paper›PMID 42201836›Full record

Trial reportDiabetes care2026

Intrapartum and Early Postpartum Use of Automated Insulin Delivery in Type 1 Diabetes: A Prespecified Analysis of the CIRCUIT Randomized Controlled Trial.

Lois E Donovan, Patricia Lemieux, Jennifer M Yamamoto, Amy D Dunlop, Helen R Murphy, Selina L Liu, Kathleen H Chaput, David Simmons, Rhonda C Bell, Jamie L Benham and 9 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Diabetes care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

19 authors.

Lois E DonovanDepartments of Medicine and Obstetrics and Gynecology, Division of Endocrinology and Metabolism, Cumming School of Medicine, University of Calgary and Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada.ORCID 0000-0001-8911-8192
Patricia LemieuxDepartment of Medicine, Division of Endocrinology and Nephrology, CHU de Quebec-Université Laval Research Centre, Quebec City, Quebec, Canada.ORCID 0000-0003-4448-9437
Jennifer M YamamotoDepartment of Internal Medicine, Division of Endocrinology and Metabolism, University of Manitoba and Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada.ORCID 0000-0002-3556-0820
Amy D DunlopDepartment of Medicine, Division of Endocrinology and Metabolism, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Helen R MurphyNorwich Medical School, University of East Anglia, Norwich, U.K.ORCID 0000-0002-5489-0614
Selina L LiuDepartment of Medicine, Department of Obstetrics & Gynaecology, Division of Endocrinology and Metabolism, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.ORCID 0000-0002-0261-0385
Kathleen H ChaputDepartments of Medicine and Obstetrics and Gynecology, Division of Endocrinology and Metabolism, Cumming School of Medicine, University of Calgary and Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada.
David SimmonsMacarthur Clinical School, Western Sydney University, Ingham Institute for Applied Medical Research, and Macarthur Diabetes Service, Campbelltown Hospital, Sydney, New South Wales, Australia.
Rhonda C BellDepartment of Agricultural, Food, and Nutritional Sciences, Division of Human Nutrition, University of Alberta, Edmonton, Alberta, Canada.
Jamie L BenhamDepartments of Medicine and Community Health Sciences, Division of Endocrinology and Metabolism, O'Brien Institute for Public Health, Cumming School of Medicine, and Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada.
Glynis P RossDiscipline of Medicine and Obstetrics, Gynecology and Neonatology, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
Kara A NerenbergDepartment of Medicine and Obstetrics and Gynecology and Community Health Sciences, Cumming School of Medicine, University of Calgary, and Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada.
Jane E BoothDepartment of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Khorshid MohammadDepartment of Pediatrics, Section of Newborn Intensive Care, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Bruce A PerkinsDepartment of Medicine, Division of Endocrinology and Metabolism, University of Toronto, Toronto, Ontario, Canada.
Susan CrawfordAlberta Perinatal Health Program, Alberta Health Services, University of Calgary, Calgary, Alberta, Canada.
George TomlinsonInstitute for Health Policy, Management and Evaluation, Toronto General Hospital Research Institute, University of Toronto, Toronto, Ontario, Canada.
Denice S FeigDepartment of Medicine, Division of Endocrinology and Metabolism, University of Toronto, Toronto, Ontario, Canada.ORCID 0000-0001-8561-7584
CIRCUIT Collaborative Group*

Funding

Buckley Family TrustDiabetes Canada and MSI Foundation of Alberta End Diabetes 100 award 2021 grant OG-3-21-5570-LDMedical Research Futures Fund 2022/MRF2023992Mount Sinai Department of Medicine Research FundUniversity of Calgary Clinical Research Fund
6 · The paper itself

Abstract

objectiveFollowing the demonstrated improvement in pregnancy glycemia with Control-IQ closed loop in the Closed-Loop Insulin Delivery by Glucose Responsive Computer Algorithms in Type 1 Diabetes Pregnancies (CIRCUIT) trial, we compared intrapartum and early postpartum glycemic effectiveness and safety with standard care in type 1 diabetes. RESEARCH DESIGN AND

methodsThe primary outcome of this prespecified analysis was percentage of time in pregnancy-specific glucose range (63-140 mg/dL) during the 24 h prior to childbirth, measured by continuous glucose monitoring. A key secondary outcome was percentage of time at <70 mg/dL in the first postpartum week, with additional secondary outcomes including continuous glucose monitoring metrics through 6 weeks postpartum. Analyses were adjusted for baseline measure, insulin delivery mode, and site.

resultsIn the intrapartum period (24 h before delivery), 39 of 44 (89%) participants continued closed loop. Intravenous insulin was used intrapartum by one (2%) closed-loop participant and 20 (45%) standard-care participants (P < 0.001). Intrapartum closed-loop users spent more time in pregnancy-specific glucose range (79.6% vs. 64.8%) than the standard-care group (mean adjusted difference 13.2 percentage points; 95% CI 5.2, 21.2). In the first postpartum week, the closed-loop group spent less time <70 mg/dL (1.7% vs. 3.2%; mean adjusted difference -1.8 percentage points; 95% CI -0.9 to -2.7) compared with the standard-care group. No maternal severe hypoglycemia occurred in the closed-loop group, while one episode occurred in the standard-care group postpartum. No diabetic ketoacidosis occurred in either group.

conclusionsUse of this closed-loop system resulted in superior intrapartum and early postpartum glycemia compared with standard care without safety concerns. Together with previous results, this supports use of this closed-loop system throughout pregnancy, labor, and the early postpartum period.

Indexed as

Diabetes Mellitus, Type 1Hypoglycemic AgentsInsulinInsulin Infusion SystemsAdultBlood GlucoseContinuous Glucose MonitoringFemaleHumansPostpartum PeriodPregnancyPregnancy in DiabeticsBlood GlucoseHypoglycemic AgentsInsulin

Identifiers

PMID42201836
PMCPMC13385504

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.