Optimizing Diabetes Management During Type 1 Diabetes Pregnancy with Automated Insulin Delivery Therapy: Clinical Impact and Economic Consequences in Spain

BACKGROUND AND AIM: The CamAPS FX automated insulin delivery (AID) system is extensively evaluated and uniquely tailored for T1D pregnancies. This study evaluated the clinical and economic implications of improving glycemia with CamAPS FX AID compared with the current standard of care (SoC). METHODS: A cost-consequence model was built leveraging data from the AiDAPT study and was adapted to the Spanish health care perspective, using local costs obtained from the literature or hospital databases. As observed in AiDAPT, women treated with AID began with an average glycated hemoglobin (HbA1c) of 7.6% (±1.1) and reached a post-treatment average of 6.0% (±0.5), demonstrating significant improvement in glycemic control. However, in the model, clinical outcomes and the resulting cost impact are based on the incremental 0.3% HbA1c reduction from the first to the third trimester using AID over SoC treatment. RESULTS: Using CamAPS FX AID instead of SoC in pregnancies complicated by T1D resulted in estimated cost savings of €1,002 per treated woman for the Spanish health care system within the first year of treatment. Of these cost savings, the majority (81%) were driven by reductions in intensive neonatal care admissions, reflecting not only marked financial savings but, more importantly, a reduction in complications and suffering among newborns. CONCLUSION: This conservative analysis captures a clinically significant impact and subsequent economic value, despite being based on only a limited number of perinatal complications. This study provides valuable insights to guide clinical practice, shape health care decision-making, and support broader adoption of technologies that improve maternal and neonatal outcomes.