TABLE 2.

Additional participant quotations.

Themes and sub‐themes		Participant quotations
CGM alone offers important benefits (… but may be a source of anxiety)		“what CGM has, does, is it … means that women can understand the impacts of their food choices on their day‐to‐day glycaemia … And then the CGM gives us much information around the impact of the food and lifestyle choices on glycaemia, that helps us to customise the insulin doses that you can to the particular person in front of you.” (HP‐014) “it enables, well, it should enable, the visualisation of results in a way that allows them to make changes themselves … the simple things like being able to see what's happening overnight. So you are able to change your insulin levels overnight … whereas before, we, we could not do that. Or it was much more difficult to do that. You were basing your overnight values on what was happening in the morning, and that was often a crude – so it improves the, the granularity of the things, the decisions that we are making.” (HP‐006) “well, ‘cause the targets they are aiming for are so tight, it's really hard – or impossible – to achieve what we are aiming at. I think being pregnant's really difficult anyway, ‘cause you feel this sort of sense of responsibility towards your unborn child … I think sometimes the CGM is a kind a of double‐edged sword, cause suddenly you are aware of all your blood sugars, and every time your blood sugar's 12, you think, ‘Am I gonna harm my baby?’” (HP‐016)
Added value of the HCL: less work … but still work		“I think they are totally transformational for women, not just in terms of glucose control, but in terms of quality of life.” (HP‐010) “the majority of women do really, really well … they are over 70% time‐in‐range, and they love it, because to achieve that, they have not had to work as hard.” (HP‐018) “what they are having to do is so much less, as well … it's less work for them definitely, while achieving better control.” (HP‐017) “one of the women said to us, in clinic … ‘(I) wake up in the morning and the first thing I think about is not diabetes, and this has been the first time in my life that I've been able to do that’.” (HP‐003) “it's not a fix (for) everything … this does not mean that you are not longer driving your diabetes. It's a case of being able to … take your eye off the ball, just a little bit. But … it does not take care of everything … you have not actually got an artificial pancreas … it's only as good as the person who's using (it).” (HP‐005)
Collaboration: a condition of maximum benefit		“… making sure that if they are using the ‘Ease‐off’, that they are using it for a good amount of time, and checking what their basal is doing before they switch it on – ‘cause if it's hardly giving any insulin anyway, (there)'s not really much point!” (HP‐002) “The issue … is the knowing when to use the ‘Boost’ and the ‘Ease‐off’ … sometimes that's an issue. And sometimes women are just boosting when perhaps they … should be looking at their bolus doses, rather than just giving a dose and then giving a boost.” (HP‐009) “where it does not work quite so well is where I suppose there's lack of engagement. So if you are not bolusing at the correct time, or you ignore your alarms … it cannot do everything … And then there's the patient who does not trust the system and is micro‐managing … they'll start boosting and everything when perhaps it needs you to let the pump do its job. But they … just cannot let go … So there's sort of two types where it's not working well.” (HP‐015) “When people aren't too controlling … the better they do, because the pump can do its thing, the algorithm can do its thing. But yeah, that's quite hard … when they are pregnant.” (HP‐001)
Respecting the HCL's role and trusting it to do its job		“We did have one woman who was probably using ‘Boost’ too often… which just did not really allow the algorithm to learn very well, because she was boosting all the time. So we discouraged it, and she seemed to settle down.” (HP‐007)
Candidacy and the provisioning of HCL technology in routine care	Difficulties predicting who would benefit	“I'm surprised how quickly a couple of people that went on it – they just took off with it. Like one woman who's a bit flaky, but ever so nice, she went on it. And we … every time we speak, she says, ‘Oh fine, brilliant’. She just took to it straightaway, and that, that was it.” (HP‐016) “the biggest limitation to using it (the HCL) … will be mis‐timed, or not given, or mis‐calculated boluses. The closed‐loop will tend to mop that up a little bit, but never as much as people think.” (HP‐014)
	Use of HCL in routine care	“I'm really hopeful they'll show benefit and … we can use it with loads more pregnant women with type 1. We can offer it … that's what I would like, you know, like we can with Dexcom. We can offer it to everyone with type 1. I'd love to be able to offer this as well.” (HP‐001) “People who have got to the point of managing their own diabetes by tinkering with everything themselves, I do think that the closed‐loop, because it's part automated, does not do as well for them … They essentially have been running themselves like an insulin pump, without having a pump.” (HP‐007) “One would hope it would be any type 1 patient would be entitled to use a closed‐loop system for the duration of their pregnancy. I would hope they would not put a “too good control” limiting factor on it, but they might … One would hope it would be equal access for everyone.” (HP‐015)