Automated Insulin Delivery (AID)

Here’s what you need to know about the latest hybrid closed loop delivery systems for diabetes management, plus how to get started if you’re new to automated insulin delivery.
Choosing an automated insulin delivery (AID) system is a major decision, on multiple levels. An AID system can drive much of your diabetes management once configured. Depending on insurance, the systems can be expensive. And some have a years-long warranty period that affects when you can get your next AID system.
If you're new to the idea of AID systems – sometimes called an artificial pancreas, bionic pancreas, or hybrid closed loop system – here's a simple explanation: a small, wearable computer uses an algorithm to calculate insulin delivered through a pump or pod based on blood sugar readings from a continuous glucose monitor (CGM).
In multiple research studies, the systems have proven to be very effective at improving time in range. They can also help prevent periods of high and low blood sugar and are especially good at flattening glucose levels overnight. People with diabetes who try an AID system for the first time are frequently surprised when they wake up each morning with blood sugars at or near their glucose targets.
This guide describes the main features of each of the commercial AID systems available today, as well as a quick look at open-source or do-it-yourself (DIY) options. Here you'll find information on the necessary components, a summary of how each system works, and the costs involved. Please note, this is not a comprehensive list of all the rapidly improving resources or products available.
Medtronic: MiniMed780G
Medtronic's most advanced AID system is the MiniMed 780G, which automatically adjusts insulin doses every five minutes based on CGM readings. The system is approved for people with type 1 diabetes ages 7 and older.
The pump
The 780G can hold up to 250 units of insulin and will work with as little as 8 units, which is useful for those who are very sensitive to insulin and some children. Dosing is handled using buttons on the pump itself, which can be helpful for those with vision issues or anyone who prefers tactile buttons. The 780G uses tubed infusion sets, which can be worn for up to seven days.
The pump screen displays CGM readings and blood sugar trends over time, as well as insulin delivery, including automatic corrections. The 780G is waterproof. The Guardian 4 sensor and transmitter it uses are water-resistant up to eight feet, but Medtronic does not recommend wearing the system while swimming.
CGM
The MiniMed 780G works with the Medtronic Guardian 4 CGM system. The Guardian 4 comes with a 7-day sensor and requires overtape to keep it in place. No finger sticks are needed to calibrate the sensor for a new CGM session, which requires a two-hour warmup time. The company recently announced new CGM options for the future – including a Medtronic CGM that uses Freestyle Libre technology and a smaller CGM called the Simplera Sync.
The MiniMed Mobile app for Apple and Android smartphones can display CGM readings and trends over time, including time in range. The app also shows how much insulin is currently being delivered, the amount of active insulin (also known as insulin on board), and automatic adjustments to basal rates and bolus corrections.
Getting started
First, you'll need to enter some settings: your basal insulin rates (up to eight segments over 24 hours), insulin to carb ratio, insulin sensitivity factor, and a blood glucose target (or range from 60 to 250 mg/dL).
To enable the SmartGuard feature, which automatically adjusts insulin dosing, you need to wear the pump and sensor for 48 hours as the system acclimatizes to your daily insulin requirements. You then enter a blood sugar reading from a glucometer before entering SmartGuard mode.
With SmartGuard active, the system adjusts basal rates based on insulin needs, CGM readings, and your blood sugar target. A target glucose level can be set to 100, 110, or 120 mg/dL. You can also set temporary targets, for example, when exercising and insulin needs are lower.
SmartGuard can automatically deliver correction boluses every five minutes, which can help with underestimated carbs at meals or missed boluses.
MiniMed 780G cost
AID system costs with insurance vary depending on your coverage. However, the cost of a new pump at the end of the warranty period is usually covered, after any deductible or copay. The MiniMed 780G warranty is for four years. Current MiniMed 770G users can upgrade to the SmartGuard-enabled 780G at no additional cost through a remote software update.
MiniMed insulin pump users not using the 770G may qualify for Medtronic’s standard four-year replacement warranty. Medtronic pump users with more than six months of warranty remaining can upgrade to the 780G for $400.
Medtronic MiniMed users whose insulin pumps fall outside the four-year warranty period can still exchange devices for a $500 credit toward the 780G. People using an in-warranty pump from another company also qualify for the $500 trade-in credit (find current pricing here).
Other helpful links for getting started:
Insulet: Omnipod 5

Insulet is currently the only maker of a commercial AID system that uses a tubeless insulin patch pump or pod, the Omnipod 5. The system is FDA-approved for people ages 2 and older with type 1 diabetes and adults 18 years or older with type 2 diabetes.
The pump
Insulet’s patch pump or pod is about half the size of a deck of cards. The pod is waterproof, has a maximum life of three days, and uses a flexible, soft plastic cannula to deliver insulin.
Treatment decisions are made using an included controller or the Omnipod 5 mobile app for iPhone and Android smartphones. The app allows the user to have full smartphone control over both basal and bolus rates. There is no way to bolus from the pod itself.
After priming using the Omnipod 5 controller or app, remove the adhesive backing and apply the pod. The cannula is inserted automatically with the tap of a button.
CGM
The Omnipod 5 works with Dexcom G6/G7 sensors for up to 10 days, and the Abbott Freestyle Libre 2 Plus for up to 15 days. The CGM and pod are connected via Bluetooth. The SmartAdjust algorithm runs from the pod, so even if the controller or a phone runs out of power (or the device is too far away to connect), the system can still run in automated mode as long as CGM readings are available.
Getting started
The Omnipod 5 uses an algorithm called SmartAdjust that’s embedded into the pod itself.
Because the pod contains the software that drives the whole AID system, users can continue in automated mode even if the smartphone or the controller is out of range or loses battery.
Users can customize their target glucose in 10 mg/dL intervals from 110 to 150 mg/dL. In automated mode, the system adjusts basal insulin rates every five minutes based on CGM readings and the amount of active insulin. The system also adapts based on a user’s total daily insulin at each pod change.
The system does not make automated corrective boluses. The Omnipod 5's bolus calculator, however, will suggest boluses to head off or correct high blood sugar based on blood sugar trends and a 60-minute prediction
In activity mode, which is designed for exercising or other periods of increased insulin sensitivity or when there is a higher risk for hypoglycemia, the glucose target can temporarily be set to 150 mg/dL.
Omnipod 5 cost
Many health insurance providers cover the Omnipod 5. Out-of-pocket costs vary depending on an individual’s insurance coverage, but the majority of Omnipod 5 users pay $50 or less per month.
Without insurance, users can expect to pay around $600 for the Omnipod 5. The Omnipod 5 app (on the provided controller or as a smartphone app) is provided at no additional cost. To check insurance coverage, visit the Omnipod site.
Other helpful links for getting started:
iLet Bionic Pancreas
The iLet Bionic Pancreas takes a novel approach to automating insulin delivery, requiring only two pieces of information: the user’s body weight and an estimation of meal size before eating. The system is FDA-approved for ages 6 and older.
The pump
The iLet uses a touch-screen pump that displays CGM readings and allows the user to perform functions including adding a blood glucose meter reading for calibration. It also allows users to review treatment history, including automated insulin doses, infusion set changes, and recent meals.
While the iLet system does not require a user to enter an exact carb amount to calculate and administer a meal bolus, it does require meal input (breakfast, lunch, or dinner). The user must also enter a meal size, such as "usual for me," "more," or "less." Meals can be input up to 15 minutes before eating. The system delivers a meal bolus after entering the meal type and size and will provide more insulin if blood sugar rises.
CGM
The Bionic Pancreas integrates with a wide selection of CGM devices to provide blood sugar readings for its algorithm. Users can choose from Abbott’s FreeStyle Libre 3 Plus or the Dexcom G6/G7.
Recently, the company released the Bionic Circle app for iPhone and Android devices. The app allows up to 10 people to remotely follow a user's blood sugar, meal, and dosing data.
Getting started
When setting up the device, the only information that users need to enter is their weight. Users are advised to update their weight if it changes by more than 15%, which could affect dosing.
Over time the system determines and adjusts the basal rate, insulin-to-carbohydrate ratio, and the amount of insulin needed to correct blood sugar that's out of the target range.
The system by default is set to a "usual" blood sugar target of 120 mg/dL. This setting can be changed to "higher" (130 mg/dL) or lower (110 mg/dL).
iLet Bionic Pancreas cost
Insurance costs vary widely, but Beta Bionics announced in 2023 that the iLet Bionic Pancreas system and monthly supplies would be covered under the pharmacy benefit for some people, which could reduce the cost considerably for those with this coverage. The system costs $3,500 without insurance.
Other helpful links for getting started:
Tandem Control-IQ: t:slim X2 and Mobi
Tandem uses its Control-IQ algorithm for automated insulin delivery in two very different insulin pumps. The t:slim X2 resembles a smartphone with a touchscreen. The newer, smaller Mobi has no screen. Instead, it's controlled by an app on an iPhone. Both pumps are FDA-approved for ages 6 and older.
The pumps
The t:slim X2 is a tubed pump with a color screen, which displays CGM readings and allows the user to bolus and make settings changes. The t:connect mobile app can also be used on iPhone and Android smartphones to view pump and CGM data, and deliver a bolus. The pump can hold up to 300 units of insulin.
The t:slim X2 is watertight and the Mobi is water resistant, but not waterproof, and should not be worn during swimming, or in hot tubs or saunas. The Mobi is about half the size of the t:slim X2 and small enough to fit in a coin pocket. The pump can hold up to 200 units of insulin. The Mobi also has a single button that allows users to bolus directly from the device.
CGM
Both the t:slim X2 and the Mobi integrate with the Dexcom G6 and G7. The t:slim X2 also works with Abbott's FreeStyle Libre 2 Plus.
Getting started
Users of either device enter the typical pump settings: basal profile, insulin-to-carb ratio, and insulin sensitivity factor. Mobi users will need to first download the Tandem Mobi app to their iPhone, which allows them to view pump and CGM data, change settings, and bolus.

Based on CGM readings and a 30-minute prediction, Control-IQ can increase basal insulin if blood sugar is predicted to rise above 160 mg/dL and deliver correction bolus doses, up to once per hour, if glucose is expected to rise above 180 mg/dL.
t:slim X2 and Mobi cost
Many health insurance plans cover the cost or a percentage for a new pump during the set warranty period. Tandem warranties are four years. Without insurance, the t:slim X2 and Mobi cost $4,000. Tandem says the average customer pays less than $50 monthly including supplies.
Other helpful links for getting started:
CamAPS FX: Another option coming to the US
Developed by the University of Cambridge, the CamAPS FX system is currently approved in Europe and the U.K. CamAPS FX has been extensively tested in clinical trials, including use in pregnancy, which requires very tight blood sugar control.
The hybrid closed-loop system is FDA-approved, but an interoperable pump is not yet available in the U.S. A compatible pump, the mylife YpsoPump, is currently under FDA review.
The pumps
CamAPS FX can be used with multiple insulin pumps currently approved for use in Europe: the YpsoPump, DANA-i, and previous-generation DANA RS pumps.
The YpsoPump is about the size of a credit card and has a touchscreen. The pump holds up to 160 units of insulin and is water-resistant. The pump cost is about $1,300.
The DANA-i and previous-generation DANA RS pumps are used primarily in Europe, Asia, and New Zealand. The pumps are known for interoperability and work with other open-source systems, including AndroidAPS. The pumps are waterproof, though most people remove them during showers and swimming, and hold a maximum of 300 units. The cost of the current DANA-i pump is $5100.
The CGMs
CamAPS FX works with the Dexcom G6 and Abbott's FreeStyle Libre 3.
Getting started
Using CamAPS FX requires an Android smartphone to set up and run the hybrid-closed loop system.
- For use with the mylife YpsoPump insulin pump, users download the CamAPS FX app from the Google Play online store.
- Users of DANA Diabecare RS and DANA-i insulin pumps will download the CamAPS FX app Amazon Appstore.
In the future, the system is planned to integrate with Apple iOS smartphones.
After installing the app and before beginning with the system, CamAPS FX requires a new user to go through an hour-long training session. Users then enter their weight and total daily insulin dose. These initial settings help indicate insulin sensitivity.
The CamAPS FX algorithm then automates insulin delivery based on blood sugar levels, amount of carbs entered, and insulin taken.
The system also includes a simple "boost" mode for when insulin needs are higher than normal, such as when experiencing stress, illness, or taking medications that affect blood sugar levels. Conversely, the system has an "ease-off" mode for when insulin needs are lower, including during physical activity or hormonal changes.
Other helpful links:
- YpsoPump overview
- CamAPS Frequently Asked Questions
- CamAPS user guide
Open-source systems
People choose to set up free, open-source AID systems for a number of reasons, including cost and the ability to fine-tune their systems. Each of the systems mentioned below is designed with safety in mind and is used by thousands of people with diabetes and their caregivers.
Note that these systems are not FDA-approved, and must be set up by the user. The American Diabetes Association 2025 Standards of Care advises healthcare providers to assist patients in optimizing AID system settings to ensure safety and effectiveness.
There are many variations on open-source systems as users can customize them. The three most used open-source systems are:
- Loop, an easy-to-use system for the iPhone. Loop has a large number of users, many of whom offer online support to those who are new to the system. The FDA has cleared a version of the software, made by the nonprofit Tidepool, for people with type 1 diabetes ages six and up. While users must install the DIY version of Loop themselves, Tidepool's FDA-approved Loop software is planned for the Apple App Store at a later date. Tidepool has partnered with Sequel Med Tech for the twiist AID system, expected to be available in 2025.
- Android APS (artificial pancreas system), which as the name implies, is controlled by an Android smartphone app and is highly customizable.
- Trio, which is very similar to Android APS and works on iPhones.
The pumps
Each of the open-source systems works with several different insulin pumps. Users should review their online guides to see which pumps are compatible with each system.
In general, the open-source systems work with a range of out-of-warranty pumps or ones that are not currently used in the manufacturers' AID systems. In other words, none of the commercially made pumps mentioned in this article will work with an open-source app. This also means there is no tech or customer support for pumps used in the open-source systems. Compatible pumps for each system include Loop, AAPS, and Trio.
The CGMs
Every AID system requires a compatible continuous glucose monitoring device to automate insulin delivery. Users should check compatibility for the system they plan to use.
Getting started
Each open-source system requires the user to build the app on their phone. The install process can be time-intensive and isn't always intuitive. Support usually comes from other users online, who also offer help for addressing technical problems and fine-tuning their open-source AID systems.
Each of the systems mentioned has a detailed startup guide, available in the links in the first part of this section.
Open-source system cost
Some systems can be set up and used for a few hundred dollars (excluding the monthly supplies, such as infusion sets). This may provide access to automated insulin delivery for those without insurance or who have other financial concerns.
The expenses for open-source AID systems vary widely depending on insurance coverage for compatible pumps, related supplies, and CGM systems. These systems are not necessarily less expensive to use depending on insurance. Before deciding on any AID system, consider the upfront and ongoing costs.
And while cost and access are important issues, safety should always be the first consideration. Consult with your healthcare provider, other people with diabetes, support groups, and diabetes educators, who are knowledgeable about these systems before choosing one.
The bottom line
Automated insulin delivery systems can help improve time in range through the use of an algorithm that communicates with an insulin pump and CGM. These systems increase insulin dosing when blood sugar is predicted by the algorithm to rise and reduce or pause insulin delivery when blood sugar is predicted to fall.
A number of commercial and open-source options are available. When choosing an AID system, some considerations include the type of insulin pump (such as tubed or tubeless), what CGM will work with the system, and how much interaction the system requires from the user.
Commercial systems are FDA-approved and come with technical support and warranties. Open-source systems are not FDA-approved, however, they can offer benefits in terms of expense and the level of user control over the systems. In open-source systems, the user must set up their own AID system and rely on online user groups for technical support.
Learn more about diabetes technology here:
- Tech Watch: The Latest in Diabetes Tech News
- AID Technology Improves Diabetes Care No Matter How You Get It
- Diabetes Tech Doubles Chance of Achieving A1C Goals for Type 1 Diabetes
- AID Systems Hit Impressive Time in Range Targets, Large Studies Show
- Could AID Transform Type 2 Diabetes Care?
- Benefits of Automated Insulin Delivery for Children