Do-It-Yourself Artificial Pancreas Systems in Type 1 Diabetes: Perspectives of Two Adult Users, a Caregiver and Three Physicians.

Advances in continuous glucose monitoring and insulin pumps have allowed people with type 1 diabetes (T1D) and caregivers to accurately and continuously measure their glucose levels and make adjustments to insulin infusion. In recent years, algorithms for subcutaneous insulin dosing have been developed that can respond to changes in glucose in an automated fashion and "close the loop". At present, a first-generation 'hybrid closed-loop', 'artificial pancreas' or 'automated insulin dosing' system, Medtronic 670G, is available commercially. Further systems are in clinical trials. Frustrated by the slow pace of innovation, people affected by diabetes have united online under the hashtag '#WeAreNotWaiting,' to disseminate open-source diabetes technologies. One dimension of #WeAreNotWaiting is "looping" with a do-it-yourself artificial pancreas. Here we provide the perspectives of two adults with T1D, the parent of a child with T1D and three physicians who detail their experience with these systems. These personal and clinical perspectives highlight very clear metabolic and psychological benefits of these systems in real-world settings.