Automated Insulin Delivery Systems

What this guide will help you understand

• What AID systems are and how they work on average
• Simple decision criteria for exploring which system may suit you
• Practical principles to get the most from whichever system you are on

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 a smartphone app) that adjusts insulin to reduce highs and lows

Current commercially available systems in the UK (January 2026):

• Medtronic 780G
• Tandem t:slim X2 with Control-IQ
• CamAPS FX
• Omnipod 5

How AID systems operate (in plain English)

• When glucose is predicted to rise above target, the algorithm tends to increase insulin (extra basal and/or an auto-correction bolus)
• When glucose is predicted to fall, the algorithm reduces or suspends insulin delivery
• You still need to enter carbohydrates eaten and bolus for meals — AID cannot yet replace meal boluses

Foundations still apply. AID is not a replacement for the basics; it is a powerful layer on top:

• Three balanced meals
• Accurate carbohydrate counting
• Bolus insulin 10–20 minutes before eating

How does the algorithm increase insulin?

Overnight, the system typically increases basal insulin when glucose rises above target. Later in the day, many systems will also deliver automatic corrections — for example, a small correction dose when glucose is predicted to remain high.

How does the algorithm decrease insulin?

To help prevent lows, basal insulin is reduced and may be suspended entirely when glucose is predicted to fall. Meal boluses still show as separate doses — the system is supporting your decisions, not replacing them.

What improvement tends to happen with AID systems?

• CGM alone: often around 40–60% time in range (TIR 3.9–10.0 mmol/L / 70–180 mg/dL)
• AID systems: commonly around 60–90% TIR
• Typical gain: +10–30 percentage points versus baseline — larger gains are often seen when starting from a lower TIR

This improvement is typically achieved with less micromanagement, not more.

Without AID, pushing beyond around 70% TIR often requires:

• Checking CGM repeatedly across the day
• Multiple correction boluses
• Frequent hypo treatments
• Ongoing trial-and-error learning

AID systems tend to let people achieve more by doing less.

The hidden superpower: sleep

One of the most consistent benefits reported is getting eight hours back. Fewer overnight hypos. Fewer wake-ups high. Flatter lines overnight — for the person with diabetes and for parents of children with Type 1.

Exploring which system may suit you

All AID systems tend to improve glucose management and quality of life. If you cannot access a specific system, the evidence suggests any of them delivers meaningful benefit.

The question is not “Which is best?” The more useful question is: Which is best for you?

Explore the individual systems