Future of Automated Insulin Delivery Systems

Advances in continuous glucose monitoring (CGM) have brought on a paradigm shift in the management of type 1 diabetes. These advances have enabled the automation of insulin delivery, where an algorithm determines the insulin delivery rate in response to the CGM values. There are multiple automated insulin delivery (AID) systems in development. A system that automates basal insulin delivery has already received Food and Drug Administration approval, andmore systems are likely to follow. As the field ofAID matures, future systemsmay incorporate additional hormones and/or multiple inputs, such as activity level. All AID systems are impacted byCGMaccuracy and futureCGMdevices must be shown to be sufficiently accurate to be safely incorporated into AID. In this article, we summarize recent achievements inAID development, with a special emphasis onCGMsensor performance, and discuss the future ofAID systems from the point of view of their input-output characteristics, form factor, and adaptability.