Bridging the confidence gap in maternity services: midwives and the rollout of diabetes technology

Management of type 1 diabetes in pregnancy is one of the most clinically demanding areas in maternity care, requiring tight glycaemic management to reduce the risk of serious maternal and neonatal complications. The introduction of continuous glucose monitoring and hybrid closed loop systems offers significant clinical benefits, but their successful implementation depends on the preparedness of the maternity workforce. This article discusses findings from a national service evaluation exploring the confidence, training and support needs of diabetes specialist midwives in relation to continuous glucose monitoring and hybrid closed loop systems use during pregnancy. The data suggest a critical mismatch between national policy and frontline readiness. To address this, the authors are calling for targeted investment in structured training pathways, multidisciplinary antenatal protocols and maternity-specific clinical leadership roles. Without such action, the transformative potential of diabetes technology in pregnancy care risks being undermined, particularly for patients from marginalised or digitally excluded groups.