Algorithmic Automated Insulin Dosing

Automated insulin delivery (AID) systems have been life-changing for people living with diabetes (PwD). AID systems, also referred to as hybrid closed loop insulin pumps, integrate an insulin pump with a continuous glucose monitoring system and utilize a control algorithm which adjusts insulin delivery in response to real-time sensor glucose levels. The goal of automated insulin delivery devices is to provide improved blood glucose control, reducing the risk of both hyperglycemia and hypoglycemia while also decreasing the burden of diabetes self-management for our patients living with diabetes. Several automated insulin delivery devices have been approved by regulatory agencies in the United States and are available for use for people living with diabetes. While these devices provide significant benefits to people with diabetes, they do not replace all diabetes self-management. Patients must still be trained in general diabetes management and understand that while using these systems both hypoglycemia and hyperglycemia may still occur. Setting realistic expectations and having patients understand they must still count carbohydrates and bolus prior to meals is key to success with these systems. Further research is looking to improve dosing algorithms and use dual hormone systems to help decrease the need for mealtime announcement and carbohydrate counting and further reduce the burden of diabetes for people living with diabetes.