The study aimed to analyze the effectiveness of artificial pancreas systems (APS) in pregnant females suffering from type 1 diabetes mellitus (T1DM) through a meta-analysis.

Notably, 5 databases, encompassing Cochrane Library, SCOPUS, Web of Science, PubMed, and EMBASE were explored for literature on APS usage among T1DM mothers. The key endpoint was 24-hour time in range (TIR; 3.5-7.8 mmol/L). Glycemic metrics over a 24-hour (mean blood glucose [MBG], time above range [TAR], time below range [TBR]), as well as overnight time in range (TIR) and TBR were the secondary outcomes ascertained.

Overall, four randomized controlled trials, encompassing 164 participants, were identified. A single study, with 16 participants, focused on the application of APS during the night, while the other three studies emphasized continuous 24-hour APS use. Using APS demonstrated a favorable impact on 24-hour TIR (standard mean difference [SMD] = 0.53, 95% confidence interval [CI] 0.25, 0.80), overnight TIR (SMD = 0.67, 95% CI 0.39, 0.95), and overnight TBR (<3.5 mmol/L; SMD = -0.49, 95% CI -0.77, -0.21) in comparison with standard care.

However, no profound difference was witnessed in 24-hour TBR, 24-hour TAR, or MBG between the study groups. Subgroup assessments were carried out, excluding the study that concentrated on overnight APS usage. These analyses revealed that the continuous 24-hour application of APS not only led to a reduction in 24-hour TIR (SMD = 0.41, 95% CI 0.12, 0.71) but also triggered a drop in 24-hour TBR (<2.8 mmol/L; SMD = -0.77, 95% CI -1.32, -0.23).

These findings indicate the potential for APS to enhance 24-hour TIR and nocturnal glycemic control, accompanied by a significant reduction in 24-hour TBR (2.8 mmol/L) among pregnant women battling T1DM.