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Efficacy, safety, and user experience of DIY or open-source artificial pancreas systems: a systematic review

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Abstract

The do-it-yourself artificial pancreas system (DIYAPS) is a patient-driven initiative with the potential to revolutionise diabetes management, automating insulin delivery with existing pumps and CGM combined with open-source algorithms. Given the considerable interest in this topic within the diabetes community, we have conducted a systematic review of DIYAPS efficacy, safety, and user experience. Following recognised procedures and reporting standards, we identified 10 eligible publications of 730 participants within the peer-reviewed literature. Overall, studies reported improvements in time in range, HbA1c (glycated haemoglobin), reduced hypoglycaemia, and improved quality of life with DIYAPS use. While results were positive, the identified studies were small, and the majority were observational and at high risk of bias. Further research including well-designed randomised trials comparing DIYAPS with appropriate comparators is recommended.

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Funding

The Department of Women’s and Children’s Health and the Department of Medicine, University of Otago.

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Authors and Affiliations

  1. Department of Women’s and Children’s Health, Dunedin School of Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand

    N. A. M. Asarani, M. Elbalshy & B. J. Wheeler

  2. Department of Medicine, Dunedin School of Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand

    A. N. Reynolds

  3. Department of Paediatrics, University of Otago, Christchurch, New Zealand

    M. Burnside & M. de Bock

  4. OpenAPS, Seattle, WA, 98101, USA

    D. M. Lewis

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  1. N. A. M. Asarani
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  2. A. N. Reynolds
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  3. M. Elbalshy
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  4. M. Burnside
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  5. M. de Bock
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Contributions

BW, NA, and AR conceived the study. All authors were involved in study design. AR and NA were involved in screening of included studies. NA and ME performed data extraction and analysis. NA drafted the initial manuscript, and this has been reviewed and revised by all authors.

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Correspondence to B. J. Wheeler.

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Asarani, N.A.M., Reynolds, A.N., Elbalshy, M. et al. Efficacy, safety, and user experience of DIY or open-source artificial pancreas systems: a systematic review. Acta Diabetol 58, 539–547 (2021). https://doi.org/10.1007/s00592-020-01623-4

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