Sistemi di somministrazione insulinica automatizzata open source: a che punto siamo?

The artificial pancreas or automated insulin delivery (AID) system is an important step forward in the treatment of diabetes. Besides commercial AID systems, open-source automated insulin delivery systems (opensource-AID), known more colloquially as “Do-it-Yourself Artificial Pancreas Systems” (DIY APS) have become available. They couple algorithms developed by patients with diabetes, with commercially available and regulatory-approved insulin pumps and continuous glucose monitoring (CGM) sensors. These closed loop systems, are categorized by the technology and algorithm they incorporate (OpenAPS, Android APS or Loop). Until now only one open-source algorithm has been approved by Food and Drug Administration. Different studies, observational, real time and randomized-controlled have shown that AID open-source systems can improve metabolic control and quality of life in patients with diabetes, while decreasing the burden of diabetes management. Aim of this paper is to summarize data from the literature and to reason about the implications that the arrival of this new technique will have for patients and caregivers.