Open-Source Insulin Pumps Work as Well as Commercial Systems for Young People With Type 1 Diabetes

A real-world study of Canadian youth found that do-it-yourself automated insulin delivery systems achieved similar blood sugar control and safety outcomes as FDA-approved commercial systems over 18 months.

PubMed indexed literature

Evidence label explains the kind of source behind this article (for example peer-reviewed literature vs community video). It is not medical advice.

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Key takeaways

Open-source automated insulin delivery systems (Loop, iAPS, AndroidAPS) performed comparably to commercial hybrid closed-loop systems in managing blood sugar levels
Both types of systems significantly improved A1C levels over 18 months, with open-source users seeing a larger decrease
Safety outcomes were similar between the two groups, with very few serious low blood sugar events and no cases of diabetic ketoacidosis
This is one of the first large pediatric studies directly comparing open-source and commercial automated insulin delivery in real-world conditions

What This Study Looked At

Researchers in British Columbia compared two different approaches to automated insulin delivery in young people with type 1 diabetes. One group used open-source systems—tools built by the diabetes community that are freely available and customizable. The other group used Tandem t:slim, a commercial FDA-approved hybrid closed-loop system. The study included 198 young people (average age 13.8 years) who used either type of system for at least six months between 2015 and 2024.

How Well Did Each System Work?

Over 18 months, both groups improved their blood sugar control. Youth using open-source systems saw their A1C drop from 7.40% to 6.96%, while those using the commercial system improved from 7.35% to 7.28%. When researchers adjusted for differences between the groups, there were no statistically significant differences in glucose management or time in range—meaning both systems kept blood sugar in target ranges at similar rates.

What About Safety?

Safety is always a top concern with insulin delivery systems. In this study, severe low blood sugar (hypoglycemia) occurred in just one participant in each group. No participants in either group experienced diabetic ketoacidosis, a serious complication of high blood sugar. These findings suggest both types of systems carried comparable safety profiles in real-world use.

Why This Matters

Open-source automated insulin delivery systems have grown in popularity because they're free and allow users to adjust settings to fit their individual needs. However, most research has focused on commercial systems with FDA approval. This study provides important evidence that open-source systems can deliver comparable results. It doesn't mean one is better than the other—rather, it shows open-source options are a legitimate choice for families seeking automated insulin delivery. Access, cost, customization preferences, and individual circumstances will guide which system works best for each person.

Evidence label

Source: Pediatric diabetes. Evidence type: PubMed indexed literature. Type1Cure is an information and intelligence hub, not a medical advice service. This article summarizes published research and does not provide diagnosis, treatment, or personal medical guidance. Always talk to your own care team before changing anything about your Type 1 diabetes management.

Type1Cure is an information and intelligence hub, not a medical advice service. This article summarizes published research and does not provide diagnosis, treatment, or personal medical guidance. Always talk to your own care team before changing anything about your Type 1 diabetes management.

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