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Updated: Nov 7, 2025

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Full closed loop open-source algorithm performance comparison in pigs with diabetes.

Rayhan A Lal1,2,3, Caitlin L Maikawa4, Dana Lewis5

  • 1Division of Endocrinology, Department of Medicine, Stanford University, Stanford, California, USA.

Clinical and Translational Medicine
|May 1, 2021
PubMed
Summary
This summary is machine-generated.

AndroidAPS demonstrated superior glucose control compared to Loop in a pig model without meal announcements. This suggests OpenAPS algorithm strategies may enhance automated insulin delivery systems for reduced patient burden.

Keywords:
automated insulin deliverydiabetesopen-source closed loop

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Area of Science:

  • Endocrinology
  • Biomedical Engineering
  • Metabolic Diseases

Background:

  • Automated insulin delivery (AID) systems aim to reduce the burden of diabetes management.
  • Eliminating meal carbohydrate entries is a key goal for fully closed-loop systems.
  • Comparing AID algorithm performance without meal announcements is crucial for clinical advancement.

Purpose of the Study:

  • To compare the glucose control efficacy of two open-source AID systems, AndroidAPS and Loop.
  • To evaluate AID performance in a preclinical model under conditions simulating unannounced meals.
  • To assess the impact of AID algorithm features on time-in-range and hypoglycemia.

Main Methods:

  • Utilized a pig model of diabetes mellitus.
  • Compared AndroidAPS and Loop AID systems under a full closed-loop configuration.
  • Monitored glycemic control without requiring manual carbohydrate intake entries.

Main Results:

  • AndroidAPS achieved 58% time-in-range (70-180 mg/dl) versus 35% for Loop.
  • Overnight time-in-range was significantly higher with AndroidAPS (90%) compared to Loop (22%).
  • AndroidAPS resulted in lower time-in-hypoglycemia during lunch meals compared to Loop.

Conclusions:

  • The OpenAPS algorithm (oref1) implemented in AndroidAPS shows improved glucose control for unannounced meals.
  • AndroidAPS demonstrates potential for better overall glycemic management in fully closed-loop systems.
  • Algorithm design, particularly strategies for handling unannounced meals, is critical for advancing AID technology.