Automated Insulin Delivery

Despite improvements in diabetes therapy provided by insulin pumps and continuous glucose monitoring (CGM) devices, most youth with T1D do not meet glycemic targets. For example, recent data from the T1D Exchange Registry continue to demonstrate that only ~17% of children under age 18 attain hemoglobin A1c levels under 7.5% (Foster et al., Diabetes Technol Ther 21:66-72, 2019). A potential explanation for the failure of current technologies alone to improve diabetes care is that they still require a considerable amount of human effort. Specifically, each successive advance in diabetes technology has come at the expense of requiring more effort and more burden. In this chapter, we explore the promise of automated insulin delivery is to improve outcomes, while simultaneously “off-loading” the burdens of diabetes self-management tasks to the diabetes device.