How It Started, How It Is Going: The Future of Artificial Pancreas Systems (Automated Insulin Delivery Systems)

Abstract

Originally, the future of automated insulin delivery (AID) systems, or artificial pancreas systems (APS), was having them at all, in any form. We’ve learned in the last half dozen years that the future of all artificial pancreas systems holds higher time in range, less work required to manage automated insulin delivery systems to improve quality of life, and the ability to input critical information back into the system itself. The data and user experience stories make it clear: APS works. APS are an improvement over other diabetes therapy methods when they are made available, accessible, and affordable. Understanding the unmet expectations of current users of first generation APS technology may also aid in the development of improved technology and user experiences for the future of APS.

Understanding the needs of people aging with type 1 diabetes: a user-focused research study with prototype diabetes advance directive and setting the stage for future research

“…These systems leverage existing insulin pumps and continuous glucose monitors (CGM) alongside an open source algorithm to adjust insulin delivery [ 41 ]. With the rise of DIY diabetes tools such as automated insulin delivery systems, we see more clearly the limitations of current commercialized tools [ 42 ] and the initiative many PWD have had to take [ 43 ] in order to meet their own specific needs. Through these DIY tools, we see a greater level of initiative and engagement by PWD than many healthcare providers typically expect.…”

‘We’re all on the same team’. Perspectives on the future of artificial pancreas systems by adults in Australia with type 1 diabetes using open‐source technologies: A qualitative study

“…7 Furthermore, they believed that commercial companies could learn from the community's user-driven approach to addressing unmet needs. 7 They also predicted future versions of APS would include the use of faster-acting insulins and dual hormones (glucagon and insulin). 1 A unique contribution of our study is that participants described a way forward for commercial companies and open-source APS not just to co-exist but to collaborate for mutual benefit.…”

“…Participants in our study stated that this customisation was needed in future commercial APS. 7 Furthermore, they believed that commercial companies could learn from the community's user-driven approach to addressing unmet needs. 7 They also predicted future versions of APS would include the use of faster-acting insulins and dual hormones (glucagon and insulin).…”

“…Although several commentaries and reviews have hypothesised on the future of open‐source APS, 2,5–7 to date there has been no qualitative research to address this question. In 2018, our aim was to conduct a qualitative study to explore the views and experiences of early adopters of open‐source APS in Australia.…”

Quantifying Input Behaviors That Influence Clinical Outcomes in Diabetes and Other Chronic Illnesses

“…5 With these open-source AID systems, lead users have shown it is possible to quantify the impact of individual input behaviors (such as meal announcement, carb counting, meal boluses, and consuming medium to higher carbohydrate meals) and their cumulative effect on preferred outcomes (~80% TIR 70-180 mg/dL and little to no hypoglycemia). 6 Additional research should be done on open-source and commercial AID systems alike to further quantify the effects of discrete behaviors of diabetes self-management while using this technology.…”