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Integration with Insulin Pumps (AID Systems)

Automated Insulin Delivery (AID) systems integrate CGMs with insulin pumps to create closed-loop systems that adjust insulin delivery in real-time.

Integration with Insulin Pumps (AID Systems)

The Artificial Pancreas

Integration with insulin pumps creates Automated Insulin Delivery (AID) or Hybrid Closed-Loop (HCL) systems—the most advanced application of CGM technology.

How AID Systems Work

The system uses a feedback loop:

  1. CGM (Sensor): Transmits glucose data
  2. Algorithm (Controller): Processes data and calculates insulin needs
  3. Pump (Actuator): Delivers adjusted insulin doses

Control Algorithms

Model Predictive Control (MPC)

  • Predicts future glucose based on current trends
  • Adjusts insulin proactively
  • Used by: Tandem Control-IQ

Proportional-Integral-Derivative (PID)

  • Responds to current glucose deviation
  • Classic control theory approach
  • Used by: Medtronic SmartGuard

Major Commercial Systems

| System | Company | CGM | Algorithm | |--------|---------|-----|-----------| | Control-IQ | Tandem | Dexcom G6/G7 | MPC | | SmartGuard | Medtronic | Guardian 4 | PID-based | | Omnipod 5 | Insulet | Dexcom G6 | MPC | | iLet | Beta Bionics | Dexcom G6 | Adaptive |

Open Source DIY Community

A robust community develops open-source AID systems:

  • Loop: iOS-based
  • OpenAPS: Android-based
  • AndroidAPS: Flexible platform

FDA Interoperability Standards

The FDA has established standards enabling mix-and-match ecosystems:

  • iCGM: Interoperable CGM designation
  • ACE Pump: Alternate Controller Enabled pump designation

Ongoing Challenges

  • Physiological lag times affecting responsiveness
  • Connectivity stability between devices
  • User training and expectations