Open-Source Automated Insulin Delivery
- Mike Sommer
- 1 day ago
- 3 min read
Updated: 4 hours ago
Open-source automated insulin delivery (AID) systems like Loop are no longer fringe technology—they’re being embraced by a growing number of people with Type 1 diabetes and recognized by major medical societies as safe, effective, and worthy of clinical support. Once considered “DIY,” these systems are now viewed as legitimate care options that healthcare professionals should understand and support. Here’s how leading medical organizations are responding:
American Diabetes Association (ADA)
The 2025 ADA Standards of Care explicitly recommend healthcare provider involvement in supporting open-source AID systems. This marks a pivotal change: the ADA now encourages clinicians to understand how Loop works and assist patients in using it safely and effectively.
Key takeaways:
Clinicians should be trained in the fundamentals of open-source AID.
Support should include setup guidance, data review, and optimization.
ADA emphasizes health equity, noting Loop can offer solutions for patients who can’t access commercial AID due to insurance or age restrictions.
By placing Loop alongside commercial AID systems, the ADA has made it clear: if it improves outcomes, providers should be involved.
Diabetes Canada
In 2023, Diabetes Canada stated that healthcare professionals have an ethical duty to support Loop and other open-source systems—especially if they already support commercial AID options.
Their position paper highlighted:
Informed discussions: All effective AID options should be presented to patients, regardless of regulatory status.
Referral encouraged: If a provider lacks experience with Loop, they should refer to a clinician or peer expert who does.
Use of Nightscout and Tidepool: These tools enable clinicians to review insulin delivery and CGM data for Loop users just like they would with commercial systems.
Diabetes Canada’s message is clear: support should follow the patient’s choice, not just what’s FDA-approved.
International Society for Pediatric and Adolescent Diabetes (ISPAD)
The 2024 ISPAD Clinical Practice Guidelines give a strong nod to open-source AID, particularly for youth. Providers experienced with pumps and CGMs are encouraged to support families using Loop—even though it's unregulated.
ISPAD encourages:
Hands-on clinical support for setup, optimization, and troubleshooting.
Respect for patient autonomy, especially when families choose Loop to improve control.
Awareness of local regulations, but with a priority on ethical, patient-centered care.
For pediatricians and diabetes educators, this endorsement reinforces the importance of not ignoring open-source tools simply because they’re community-driven.
International Consensus Statement
In 2021, 44 healthcare professionals and legal experts from 20+ countries published a consensus statement in The Lancet Diabetes & Endocrinology, offering ethical and practical guidance on supporting Loop users.
Recommendations include:
Shared decision-making: Loop should be discussed as a valid option, especially when commercial AID is inaccessible.
Professional education: Providers should learn how Loop works or refer to someone who does.
Legal awareness: Withholding support from a patient using Loop may be unethical; document informed conversations and risks.
Clinical oversight: Nightscout, LoopDocs, and OpenAPS documentation help providers understand algorithm behavior and data interpretation.
This document firmly positions Loop support within the provider’s scope—especially when it improves outcomes.
EASD and ISPAD Joint Guidance on AID and Exercise
A 2023 joint position statement by the European Association for the Study of Diabetes (EASD) and ISPAD includes Loop in its guidance for AID during exercise. It urges clinicians to support patients using any AID system, including open-source, during physical activity.
They recommend:
Understanding how Loop’s algorithm adjusts insulin during activity.
Helping users configure temporary targets and safe settings for exercise.
Supporting data sharing via Nightscout or Tidepool for review of patterns post-activity.
This shows that support for Loop now extends to specific care contexts—like sports and exercise.
What This Means for Healthcare Providers
Medical societies around the world agree: supporting open-source AID is no longer optional. Healthcare professionals should:
Learn how Loop works using community documentation like LoopDocs.
Review patient data using Nightscout or Tidepool and provide optimization feedback.
Refer when needed to expert peers or Loop coaches for onboarding or technical help.
Treat Loop as a valid, evidence-based tool that improves glycemic outcomes and quality of life.
More importantly, don’t let regulatory hesitation prevent better care. If the patient chooses Loop and it’s working well, providers should step in, not step away.
Conclusion
From the ADA to ISPAD to Diabetes Canada, the message is unified: if patients are using Loop, or other OSAIDs, providers should support them. Open-source AID is safe, effective, and often the most accessible option for people living with Type 1 diabetes.
By becoming informed allies, healthcare providers can help people with T1D unlock the full potential of data-driven, automated insulin delivery and remote patient monitoring.
Mike Sommer
Just Another T1d
952-380-6854
Commentaires