Overview
AID or HCL Systems:
- Use an algorithm (set of instructions) and CGM results to adjust insulin delivery up, down or off to reduce hyperglycemia and hypoglycemia. Adjustments may include modulating basal insulin and/or adding micro-corrections.
- Require manual input of estimated grams of carb to determine meal boluses (in most cases)
- Exist in some brands of commercially available insulin pumps (Health Canada approved)
- Exist in DIY versions (not Health Canada approved). The two most common algorithms used in DIY AID are 1. Loop and 2. Oref based (OpenAPS, AndroidAPS, FreeAPSX).
- Use algorithms that are brand specific. Each algorithm allows for different factors to be adjusted while the system is automatically adjusting insulin. (The older concept of 50/50 basal & bolus insulin split may not apply.)
Comparison of Common AID Systems
Also consider the U.S. site (options may vary): https://www.pantherprogram.org/device-comparison
Features that may/may not be adjusted in AID mode | Medtronic 670G, 770G (AutoMode) - tubing | Medtronic 780 (SmartGuard) - tubing | Tandem (Control IQ) - tubing | Loop DIY - tubing (old Medtronics) or Omnipod |
Sensor Type | Guardian 3 (calibration required) |
Guardian 3 (calibration required |
Dexcom (calibration optional) | Dexcom (calibration optional) |
Glucose Targets (mmol/L) |
6.7 8.3 |
5.5 6.1 6.7 8.3 Note: Corrections target 6.7 |
6.25 - 8.9 6.25 - 6.7 (sleep activity) 7.8 - 8.9 (exercise activity) Note: Corrections target 6.1 |
Freely customizable |
Auto-Correction Boluses can be toggled on/off by user? | N/A |
Yes. Auto Corrections can be turned off while SmartGuard will still modulate basals. |
Yes, if Sleep Activity enabled no auto-corrections are delivered. Control IQ includes auto-corrections. (Changing other settings can impact the corrections.) |
Yes. Dosing strategy can be auto-bolus or temp basal only. |
Basal Rates adjusted by user? | No | No | Yes | Yes |
ISF adjusted by user? | No | No | Yes | Yes |
Carb Ratio adjusted by user? | Yes | Yes | Yes | Yes |
Suggested Boluses adjusted by user? | No | No | Yes | Yes |
Extended Bolus can be set? | No | No | Yes, max 2 hr | Yes in terms of carb absorption time |
Insulin Action Time can be adjusted? | Yes (2-6 hr) | Yes (2-6 hr) | No (5 hr) | Not usually. Preset when choose insulin type. (Choosing Walsh insulin model allows to set different duration). |
OpenAPS, Android APS, FreeAPSX all use the Oref algorithm and are not yet represented above.
Addressing Hyperglyemia in AID*
Medtronic 780G** | Tandem CIQ | Loop DIY |
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*Patients should be directed to pump company resources. These options may not be as indicated in product manuals. Options for possible consideration if appropriate and applicable as reviewed with healthprovider and patient. Not all options are ideal. Some are temporary. |
Addressing Hypoglycemia in AID*
Medtronic 780G** | Tandem CIQ | Loop DIY |
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*Patients should be directed to pump company resources.These options may not be as indicated in product manuals. Options for possible consideration if appropriate and applicable as reviewed with healthprovider and patient. Not all options are ideal. Some are temporary. |
Exercise Planning in AID*
Medtronic 780G** | Tandem CIQ | Loop DIY |
**670G, 770G same options except there are no Auto Corrections to turn off and only 2 glucose targets to choose from. |
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Eat small amounts carb with no bolus - use with caution. Elevations in glucose may result in auto-corrections or increased basal during period of exercise. | ||
*Patients should be directed to pump company resources.These options may not be as indicated in product manuals. Options for possible consideration if appropriate and applicable as reviewed with healthprovider and patient. Not all options are ideal. |