Automated insulin delivery systems are small computerized medical devices that integrate a continuous glucose monitor, an insulin pump that continuously delivers insulin to the patient, and a control algorithm that automatically adjusts insulin delivery to maintain stable blood glucose levels. Research shows that automated insulin delivery systems typically achieve superior glucose control compared to traditional insulin treatment (e.g., multiple daily injections), reducing complications such as severe hypoglycaemia (life threatening reduction in blood glucose) and hospitalizations. High costs, treatment complexity, and risk of acute events (like diabetic ketoacidosis) make accessible automated insulin delivery solutions critical. Because insulin remains a cornerstone therapy, these systems are critical enough to remain vital even if new treatments emerge.
The main stakeholders are people with type 1 diabetes (requiring insulin daily) or insulin-dependent type 2 diabetes who live in very diverse settings. These settings include resource-limited regions where cost and availability of technology pose significant barriers.
Most insulin users rely on multiple daily injections. Insulin pumps and commercial or do-it-yourself fully or partially automated insulin delivery systems that integrate continuous glucose monitors are also available, but are expensive and require that the users are comfortable with technology. Assumptions embedded in current practice (e.g., guaranteed access to continuous glucose monitors or reliable internet access) may also not be applicable for individuals who live in resource-limited regions. This further limits the adoption of automated insulin delivery systems.
Automated insulin delivery, both full and partial (hybrid closed-loop system), are superior to insulin injections. Recent trials have also demonstrated significant improvements among people with type 2 diabetes who are injecting insulin and medications that increase natural insulin secretion (e.g., Ozempic). These trials have led to regulatory approval of two automated insulin delivery systems for type 2 diabetes (Insulet’s Omnipod 5 and Tandem’s Control-IQ+).
Affordable, Intelligent, and Durable Insulin Delivery: A low-cost, automated insulin delivery system that is easy to use and interacts seamlessly with minimally invasive glucose monitors for optimized diabetes control.
Additional Considerations:
The hardware, sensors, and regularly replaced parts (e.g., infusion sets, CGM sensors) can be prohibitively expensive.
Setup and maintenance of current systems require training and comfort with technology..
There are opportunities for user-centred design in maintenance and data interpretation. Opportunities also exist for patch-based insulin delivery that is less bulky, without tubing, and minimizes errors in insertion.
