The ROKSANA study is an open-label crossover RCT with the aim to evaluate whether sensor-augmented pump therapy (SAP) with predictive low glucose suspend technology is associated with an increased risk for ketonaemia during type 1 diabetes pregnancies.

10 pregnant women with type 1 diabetes will be included . Participants will be randomized 1/1 between 12-30 weeks of pregnancy to SAP with predictive stop before low during two weeks or predictive stop on low. Participants will be cross-over to the other group after two weeks (from stop before low to stop on low or vice versa). During the study, participants will be asked to measure blood ketones three times per day.

Inclusion Criteria:

• type 1 diabetes
• age 18-45 years
• a singleton pregnancy with ultrasound-confirmed gestational age between 12- 30 weeks.
• treated with 640 insulin pump and have a baseline HbA1c level ≤10%.

Exclusion Criteria:

• a physical or psychological disease likely to interfere with the conduct of the study
• medications known to interfere with glucose metabolism