Adhering to the principle of skin in the game, I spent seven years (2017–2025) gaining personal and professional experience before writing this guide.
Want a lighter, more entertaining version first?
Try the superhero comparison guide:
Choosing an AID System: Which Superhero Do You Want in Your Corner?
Prefer to listen?
Episode 1: Choosing Your AID Superhero – we compare leading AID systems to superheroes to help you find the one that fits your style.
Still here? Excellent – this is the comprehensive guide.
I have personally tried Medtronic 670G/780G, Tandem t:slim X2 with Control-IQ, Omnipod 5, DIY Loop, and Android APS. In clinical practice, I have helped more than 300 children and young people start on every commercially available AID system.
Short version: they are all game-changers.
Choosing between them is like choosing a supercar: no single “best system”, only the right one for you.
If you work in healthcare or love the detail, try the:
AID System Study Day
This guide will help you:
- Understand what AID systems are and how they work.
- Apply simple decision-making criteria when choosing a system.
- Use practical tips to get the most out of whichever system you choose.
What are AID systems and how do they work?
AID systems combine three components:
- An insulin pump.
- A CGM device.
- An algorithm (in the pump or smartphone app) that adjusts insulin to reduce highs and lows.
Current commercially available systems (March 2025):
- Medtronic 780G
- Tandem t:slim X2 with Control-IQ
- CamAPS FX
- Omnipod 5
- DIY systems:
All AID systems operate similarly:
- When glucose is predicted to rise above target, the algorithm increases insulin (extra basal or auto-correction bolus).
- When glucose is predicted to fall, it reduces or suspends insulin delivery.
- You must still enter carbohydrates eaten and bolus for meals. AID systems cannot yet replace food boluses.
Foundations still apply: three balanced meals, accurate carb counting, and giving bolus insulin 10–20 minutes before eating.
How does the algorithm increase insulin?
Overnight it increases basal when glucose rises above target; later in the day it may deliver an automatic correction (e.g. 0.4 units at 16:30).
How does the algorithm decrease insulin?
Suspended basal insulin (pink bars) prevents lows. Before suspension, basal is usually reduced first. Meal boluses still appear (e.g. 3.3 units at 09:49 and 11.7 units at 17:36).
Expected improvement with AID systems
- CGM alone: ~60% time in range (TIR).
- PLGS pumps: little change in TIR.
- AID systems: typically >70% TIR, sometimes >90%.
- Clinically, people usually gain 10–30 percentage points vs baseline (larger gains when starting lower).
This improvement is achieved with less micromanagement, not more. Without AID, achieving >70% TIR often requires:
- Checking CGM 20–50 times daily.
- Multiple correction boluses.
- Frequent hypo treatments.
- Ongoing trial-and-error learning.
AID systems let you get more by doing less.
The hidden superpower: sleep
You get your eight hours back.
No more night-time hypos. No more waking high. Flatter lines overnight for you (and for parents of children with type 1).
Choosing your system
All AID systems improve glucose control and quality of life. If you cannot access a specific one, do not stress. They all deliver similar benefits.
For fun, compare them here:
Choosing an AID System: Which Superhero?
Ready to explore the systems?
