Looping and Getting Knocked Up

Dear Dr. Edelman,

I was just curious, is it safe to Loop while pregnant?

Dr. Edelman: For you Looping virgins, Looping is when you are on an insulin pump that uses software that allows communication with a continuous glucose monitor to automatically modulate your basal rate 24/7 in an effort to keep you in range as much as possible. Currently we have three systems that modulate the basal rate and are also called hybrid closed looped pumps:

1. Control IQ (T-Slim/Dexcom G6)
2. Medtronic 670G/Guardian Sensor 3 and
3. Looping with an Omnipod or older hackable Medtronic pump.

(For info about my experience Looping with an Omnipod, click here) FYI, Looping is not officially approved by the FDA at this time.

The issue of being pregnant with these systems pertains to using a pump with or without communication to a CGM device. One of the things that can happen to pumpers is sudden onset of DKA or diabetic ketoacidosis. This is a situation that occurs if the pump infusion line accidentally pulls out of the body and the wearer has no idea it happened. The insulin levels become very low quickly because pumpers do not use long acting insulin. Since insulin is needed for glucose to enter the cells of the body for energy, the brain tells the body to start breaking down fat for energy (ketosis) and this changes the delicate acid base balance in the blood to cause DKA. The problem with a pregnant woman going into DKA is that it can cause serious harm to the fetus and more often than not leads to a miscarriage.

If someone was put on a pump or was looping before getting pregnant and is experienced with how to use their particular pump or hybrid closed loop system, then yes she can safely become pregnant and continue using the system. If a woman is on multiple daily injections and gets pregnant, then I personally would not want her to start looping or go on a pump since many errors occur when inexperienced people are just starting out on these systems.