Efficacy, safety, and user experience of DIY or open-source artificial pancreas systems: a systematic review

Acta Diabetol. 2021 May;58(5):539-547. doi: 10.1007/s00592-020-01623-4. Epub 2020 Oct 31.

Abstract

The do-it-yourself artificial pancreas system (DIYAPS) is a patient-driven initiative with the potential to revolutionise diabetes management, automating insulin delivery with existing pumps and CGM combined with open-source algorithms. Given the considerable interest in this topic within the diabetes community, we have conducted a systematic review of DIYAPS efficacy, safety, and user experience. Following recognised procedures and reporting standards, we identified 10 eligible publications of 730 participants within the peer-reviewed literature. Overall, studies reported improvements in time in range, HbA1c (glycated haemoglobin), reduced hypoglycaemia, and improved quality of life with DIYAPS use. While results were positive, the identified studies were small, and the majority were observational and at high risk of bias. Further research including well-designed randomised trials comparing DIYAPS with appropriate comparators is recommended.

Keywords: Artificial pancreas; Do-it-yourself; Glucose sensing technology; Open-source.

Publication types

  • Systematic Review

MeSH terms

  • Adult
  • Blood Glucose Self-Monitoring / adverse effects
  • Blood Glucose Self-Monitoring / instrumentation
  • Blood Glucose Self-Monitoring / methods
  • Diabetes Mellitus, Type 1* / blood
  • Diabetes Mellitus, Type 1* / epidemiology
  • Diabetes Mellitus, Type 1* / therapy
  • Glycated Hemoglobin / analysis
  • Glycated Hemoglobin / metabolism
  • Glycemic Control* / adverse effects
  • Glycemic Control* / instrumentation
  • Glycemic Control* / methods
  • Glycemic Control* / statistics & numerical data
  • Humans
  • Hypoglycemia / chemically induced
  • Hypoglycemia / epidemiology
  • Insulin / administration & dosage
  • Insulin / adverse effects
  • Insulin Infusion Systems / adverse effects
  • Pancreas, Artificial* / adverse effects
  • Pancreas, Artificial* / statistics & numerical data
  • Patient Satisfaction / statistics & numerical data
  • Quality of Life
  • Self-Management* / methods
  • Self-Management* / statistics & numerical data
  • Treatment Outcome

Substances

  • Glycated Hemoglobin A
  • Insulin