Conversion from Multiple Daily Injections (MDI) to Insulin Pump Therapy in Pregnancy
Pregnancy-focused considerations when switching from MDI to insulin pump therapy and comparing: Medtronic MiniMed™ 780G, Omnipod® 5, and iLet® Bionic Pancreas.
Manuals & help (manufacturer resources)
MiniMed™ 780G
Official manuals, downloads, and Medtronic technical support.
Omnipod® 5
Official user guide and Insulet product support.
iLet® Bionic Pancreas
Official Beta Bionics user guide and support contacts.
Pregnancy glucose targets (reference)
Common SMBG targets used in pregnancy
- Fasting: < 95 mg/dL (many clinicians aim ~90)
- 1-hour postprandial: < 140 mg/dL
- 2-hour postprandial: < 120 mg/dL
CGM “pregnancy time-in-range” is often referenced as 63–140 mg/dL.
Manual mode vs automated mode (why this matters for “fasting to < 95”)
Important: In automated modes, the algorithm target is limited by device design. In manual mode, fasting goals are typically approached by titrating basal delivery (and meal bolusing).
- Manual mode = user-programmed settings (basal schedule, ICR, ISF).
- Automated/AID mode = algorithm uses a device-defined target setpoint; if the lowest target is above pregnancy fasting goals, fasting may trend higher.
Device comparison (mobile friendly)
| Feature | Medtronic MiniMed™ 780G | Omnipod® 5 (SmartAdjust™) | iLet® Bionic Pancreas |
|---|---|---|---|
| Manual mode available? |
Yes
Manual Mode uses programmed basal + bolus settings; SmartGuard does not use manual basal rates.
|
Yes
Automated and Manual modes; Manual uses user-defined basal programs.
|
No
iLet does not use programmed basal rates / ICR / correction factors; basal is set by the algorithm.
|
| Algorithm target options (automated mode) |
SmartGuard target options:
100
110
120 mg/dL
|
Target Glucose:
110–150 mg/dL
|
Predefined targets:
110
120
130 mg/dL
|
| Can you set an explicit target of 90 mg/dL? |
No
Lowest SmartGuard target is 100 mg/dL; manual mode is where basal can be titrated toward fasting goals.
|
No
Lowest automated target is 110 mg/dL; manual mode allows basal titration.
|
No
Targets are preset and cannot be adjusted into typical pregnancy fasting ranges.
|
| Pregnancy status (labeling) | Not studied in pregnant women (US labeling) | Do NOT use SmartAdjust in pregnant women (FDA special controls) |
Not recommended in pregnancy
Not indicated for pregnancy; preset targets cannot be adjusted to desired pregnancy ranges.
|
MDI → Pump starting settings (Quick Worksheet) BETA TESTING
Quick-start worksheet
Enter recent MDI doses → review starting points (then individualize).
Inputs
Definitions
TDD = Total Daily Dose (basal + bolus).
ICR = Insulin-to-Carbohydrate Ratio (grams covered by 1 unit).
ISF = Insulin Sensitivity Factor (mg/dL lowered by 1 unit).
TDD = Total Daily Dose (basal + bolus).
ICR = Insulin-to-Carbohydrate Ratio (grams covered by 1 unit).
ISF = Insulin Sensitivity Factor (mg/dL lowered by 1 unit).
Results (starting points)
TDD (MDI)
—U/day
TDD (Pump start)
—U/day
Basal total
—U/day
Basal hourly (average)
—U/hr
ICR (500 rule)
—g/U
ISF (1800 rule)
—mg/dL per 1U
Manual mode fasting strategy: adjust overnight basal gradually while monitoring for nocturnal hypoglycemia. Automated modes may have higher target floors.
GO TO Insulin Pump Basal Rate Calculator
GO TO Insulin Pump Basal Rate Calculator
Disclaimer: Starting heuristics only (e.g., 500 rule; 1800 rule). Confirm and individualize settings with a diabetes-in-pregnancy team.