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Practical Considerations and Implementation of Automated Insulin Delivery Systems
Laurel H Messer1,2, Gregory P Forlenza1, Linda Gonder-Frederick3
1Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Journal of Diabetes Science and Technology
|July 1, 2025
Summary
Automated insulin delivery (AID) offers new diabetes management possibilities but faces challenges in cost, access, and user trust. Addressing these barriers and prioritizing patient experience is crucial for widespread adoption and equitable use of AID technology.
Area of Science:
- Endocrinology and Metabolic Diseases
- Medical Technology
- Health Services Research
Background:
- Automated insulin delivery (AID) systems represent significant technological advancements for diabetes management.
- Current implementation faces challenges including cost, access, healthcare professional (HCP) endorsement, and user experience, leading to uneven adoption.
- Addressing these barriers is essential for the broad and equitable implementation of AID technologies.
Purpose of the Study:
- To explore the challenges and opportunities associated with the widespread implementation of automated insulin delivery (AID) systems.
- To identify strategies for overcoming barriers to AID uptake and promoting its equitable use among people with diabetes (PWD).
- To emphasize the importance of patient-centered approaches and healthcare system integration for successful AID deployment.
Main Methods:
- The study synthesizes current knowledge on AID implementation, considering technological, clinical, and socioeconomic factors.
- It analyzes disparities in AID uptake observed in clinical trials and routine care.
- It proposes multi-level strategies for addressing barriers and facilitating broader adoption.
Main Results:
- Uneven uptake of AID is influenced by factors beyond physiological and technological variations, including cost, access, and HCP experience.
- Prioritizing the lived experience of PWD, managing expectations, and building trust are key for effective AID use.
- Disparities in AID access and utilization persist, necessitating interventions targeting HCP biases, insurance policies, and healthcare system integration.
Conclusions:
- Successful and equitable implementation of AID requires a holistic approach, addressing patient needs, HCP education, and systemic barriers.
- Transforming clinical paradigms and fostering collaboration among all stakeholders (PWD, HCPs, researchers, policymakers, industry) is vital.
- Continued focus on alleviating burden and promoting well-being for PWD using AID is paramount for its long-term success.
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