Automated Insulin Delivery

Editors
Leonor Corsino, MD, MHS, FACE
Ramon Martinez, MD

Additional Resources
NIDDK (NIH)

Closed-Loop Therapy

Most blood glucose management systems are considered open-loop which means a system along with “human help” is used to set insulin doses. Newer technology is exploring the closed-loop system which are wearable devices that work with less help from humans. The nickname for these closed-loop systems is “artificial pancreas.” The main functionality of the artificial pancreas would mimic a human pancreas delivering the exact dose of insulin as needed automatically. This device does not replace the actual organ only taking over some of the organ’s responsibilities.

Considerations for closed-loop therapy:

  • Are you living with Type 1 diabetes?
  • Are you living with difficult to control diabetes?
  • Are you comfortable with using technology?
  • Will insurance/cost be an issue?

Terms you should know:

Open-loop: Continuous blood glucose readings through an insulin pump or a continuous glucose monitoring (CGM) system. The user monitors these readings and adjusts insulin dosages in response to blood glucose levels.

Hybrid closed-loop: A system that continually adjusts insulin delivery except for meal time. The bolus dose is still administered by the user.

Closed-loop system: A continuous cycle insulin of insulin delivery is administered using an algorithm to determine changes in glucose levels then gives the dose automatically without “human help.”

Questions to ask your healthcare provider:

  1. What types of closed-loop systems are available?
  2. Is the closed-loop system right for me?
  3. Can you recommend any clinical trials?

Edited: November 2018