Open this photo in gallery:
Alexandra Yeryomin, who lives with type 1 diabetes, with her newborn at home in Montreal on Saturday.Lisa Milosavljevic/The Globe and Mail
Like so many first-time expectant mothers before her, Alexandra Yeryomin heard a common refrain throughout her pregnancy: “You’re not going to sleep very much when that baby comes!”
She would laugh and respond that she was used to it. After all, she already had a “diabetes baby” that was waking her with its “cries,” sometimes three times in a single night.
“I have alarms in the night because of my Type 1 diabetes,” she says, referring to the beeping alerts triggered by her glucose monitoring device. “Your blood sugar is low and you have to do something about it — now.”
Ms. Yeryomin, a 26-year-old graduate student in Montreal, had only been living with her Type 1 diabetes diagnosis for nine months when she became pregnant in February.
Learning to manage a potentially life-threatening condition while navigating her first pregnancy was overwhelming, to say the least. But Ms. Yeryomin considers herself lucky because she had a critical resource: an automated insulin delivery system, or AID.
How much exercise is safe during pregnancy?
Over the last decade, AID systems have revolutionized diabetes care for patients who can access them. In Type 1 diabetes, a person’s pancreas can no longer make insulin, the hormone that helps glucose move into the body’s cells to be used for energy. But AID systems step in to act as a kind of artificial pancreas, combining three technologies to monitor glucose levels, calculate insulin needs and deliver insulin to the patient, sometimes in micro amounts.
For Ms. Yeryomin, these medical devices are a “game changer” during pregnancy, when both the risks and stress of Type 1 diabetes are amplified. But until recently, none of Canada’s four commercially available systems had been approved for use in pregnancy in North America.
Open this photo in gallery:
Ms. Yeryomin had only been living with her Type 1 diabetes diagnosis for nine months when she became pregnant.Lisa Milosavljevic/The Globe and Mail
This is finally changing. On Oct. 30, a system called myLoop became the first to receive Health Canada clearance for use in pregnancy for Type 1 diabetes, according to mylife Diabetes Care, the company behind the system.
(This means that all three components of the system, along with their integration, are now approved for use in pregnancy. On its website, mylife Diabetes Care said it’s targeting late 2026 or early 2027 for one component, the glucose monitor, to become commercially available. Health Canada was unable to respond to The Globe and Mail’s questions by deadline.)
A similar milestone was also recently met in the United States where, in April, a different system branded as Control-IQ+ became the first to receive Food and Drug Administration clearance for managing Type 1 diabetes in pregnancy.
While many Type 1 diabetes patients were already using the systems off-label in pregnancy, experts say regulatory approvals help improve access, enabling more health care providers to feel comfortable prescribing them and potentially expanding public funding or insurance coverage.
“We have come a very long way in how we manage glucose during pregnancy,” says Ilana Halperin, an endocrinologist with Sunnybrook Hospital and associate professor with the University of Toronto (Dr. Halperin does advisory work for diabetes technology companies, including mylife Diabetes Care).
“We’ve finally gotten to a place with our technology where we can make a really meaningful impact on a reduction in those diabetes complications. It’s remarkably changed the face of diabetes management.”
Mississippi’s maternity deserts deliver a political crisis
Type 1 diabetes is an autoimmune condition affecting around 300,000 Canadians. In the pre-insulin era, pregnancy was often fatal for women with diabetes, according to Lois Donovan, an endocrinologist and clinical professor with the University of Calgary’s Cumming School of Medicine.
Nowadays, a safe and healthy pregnancy is not only possible, it’s a common outcome for women living with Type 1 diabetes, she says.
“I’m very excited about the advancements that AID have brought,” says Dr. Donovan, who co-led an international trial of an AID system using the Control-IQ technology. “I have lived through joys and tears with women over the years, and it’s just so exciting to be able to have more joys than tears these days.”
But Dr. Donovan never sugarcoats the situation with her patients; even with these new technologies, managing Type 1 diabetes in pregnancy is still incredibly hard work, she says.
Pregnancy is a particularly volatile time for blood sugars. The placenta releases hormones that increase insulin resistance, and many features of a typical pregnancy — like morning sickness, food cravings and disturbed sleep — can wreak havoc on blood sugar levels.
And pregnancy, already anxiety-inducing in the best of times, can be even more stressful with Type 1 diabetes in the mix. For the mother, pre-existing diabetes complications may worsen, and the risks of preeclampsia or miscarriage are heightened. For the baby, high blood sugars can lead to birth defects or babies born large for gestational age, which raises the risk of a difficult delivery or birth trauma.
“The sense of stress and failure and anxiety that I see in these women is insane,” Dr. Halperin says, adding that stressed and anxious expectant mothers are at high risk for postpartum depression. “Every time they see a high blood sugar, they have this kind of anxiety or panic feeling that they’re maybe harming their baby.”
AID systems go a long way toward relieving the stress and mental burdens of managing Type 1 diabetes, she says.
Open this photo in gallery:
Ms. Yeryomin’s baby boy was born without complications in October.Lisa Milosavljevic/The Globe and Mail
A growing body of research is also demonstrating the clear benefits of using AID systems in pregnancy. Studies have shown that continuous glucose monitoring, one of the components in AID systems, improves neonatal outcomes. Major trials of some AID systems have also demonstrated significant improvements in the amount of time patients spend within their target glucose range.
When Ms. Yeryomin was diagnosed with Type 1 diabetes in May, 2025, the first question she asked her endocrinologist was about whether she could safely deliver a healthy baby.
Today, she is enjoying her new life with a healthy baby boy, Justinian, who was born on Oct. 19 with no complications.
“I’m very grateful,” she says of her AID system. “Maybe it sounds a bit dramatic, but I just don’t know if I would be here talking about my baby right now otherwise.”