Choosing an AID System: Which Superhero?

Do you prefer control and flexibility like Spider-Man?

Do you want a powerful, aggressive system like Hulk?

Do you need a highly adaptable, strategic system like Batman?

Or do you want a sleek, simple, and futuristic option like Iron Man?

This guide compares four leading AID systems — Tandem t:slim X2 with Control-IQ, Medtronic 780G, CamAPS FX, and Omnipod 5 — through the lens of the superheroes they most resemble.

Want the podcast version? Episode 1: Choosing your AID Superhero compares the top AID systems to superheroes, exploring which might best suit your management style — whether you need control like Spider-Man, power like Hulk, strategic adaptability like Batman, or sleek automation like Iron Man.

For a more comprehensive (if less fun) comparison, the AID system guide covers each system in depth.

Tandem t:slim X2 with Control-IQ — Spider-Man

“With great power comes great responsibility.”

Just like Peter Parker, Control-IQ provides considerable power — but that power comes with responsibility. The system offers manual control over basal rates and correction factors (the most important driver of the algorithm), along with multiple profiles, making it highly customisable to varying insulin sensitivity across different times of day and different days.

However, this level of control requires maintenance. Settings need regular updating based on changing insulin needs — particularly in children and adolescents, whose insulin sensitivity fluctuates more frequently.

Strengths:

• Highly customisable, with multiple insulin profiles
• Well suited to those who prefer hands-on involvement in their management
• Activity and Sleep modes to support time in target

Considerations:

• Requires regular basal rate and correction factor updates to allow the algorithm to perform well
• Less aggressive in correcting post-meal glucose rises compared to some other systems — the algorithm increases insulin delivery when predicted glucose is above 8.9 mmol/L (160 mg/dL)
• Requires manual upload to Glooko via a computer with a USB port to review glucose data

Often suits: adults or highly engaged caregivers; children and adolescents whose families want meaningful involvement in setting management.

Medtronic 780G — The Incredible Hulk

“The strongest there is — built to crush after-meal highs!”

The Medtronic 780G is a powerful, aggressive system designed to work hard against hyperglycaemia. With an active insulin time of two hours and a glucose target of 5.5 mmol/L (100 mg/dL), it delivers autocorrection boluses more aggressively than most other systems — and has the potential to address post-meal rises faster as a result.

Just like Hulk’s strength can be unpredictable, the 780G’s tendency to push insulin on board after meals can lead to glucose lows when activity levels are variable. It tends to work best when daily routines are fairly consistent.

One important consideration: the 780G currently requires Medtronic’s own CGM sensors (Guardian 3, Guardian 4, or Simplera), which do not hold iCGM certification. Evidence suggests the Simplera sensor may underreport high glucose levels compared to some other sensors — see Pemberton et al, 2025. A future partnership with Abbott for Freestyle Libre integration is expected to address this. Standardisation of CGM accuracy testing via an ISO standard would benefit the whole field.

Strengths:

• The most aggressive system currently available for managing post-meal glucose rises
• Highly automated, requiring minimal user intervention day-to-day
• Strong overnight glucose control

Considerations:

• Aggressive after-meal corrections can lead to unexpected glucose lows when activity is variable, due to high levels of insulin on board
• Requires Medtronic’s own CGM sensors, which currently lack iCGM certification
• Cannot customise glucose target across different times of day to account for variable insulin sensitivity

Often suits: those who want high automation and strong post-meal glucose management, particularly people with stable daily routines.

CamAPS FX — Batman

“With planning and preparation, I can beat anyone.”

Batman relies on preparation and strategy — and so does CamAPS FX. This system offers the most customisable glucose target settings of any current AID system: targets from 4.4 to 11.0 mmol/L (80 to 200 mg/dL) across up to 48 time blocks, combined with a continuously adapting algorithm and a rich set of announcement features.

Boost mode increases aggressiveness when insulin insensitivity is detected; Ease-off mode reduces it around exercise or sensitivity. Add Meal options allow manual announcements for hypo treatment carbohydrates and slowly absorbed high-fat meals.

Much like Batman relies on his gadgets, CamAPS FX runs from a smartphone. The phone must be kept close at all times for the system to operate — and users need to engage with the additional features to get the most out of the system.

Strengths:

• The most adaptable system — multiple glucose targets across the day, and manual announcement of hypoglycaemia carbs and high-fat meals
• Well suited for people needing tight glucose management, including during pregnancy
• The most researched AID system across all age groups, with a continuously adapting algorithm

Considerations:

• Requires an Android phone (not iPhone-compatible as of March 2025)
• Realising its full potential requires learning when and how to use the different features
• Phone must remain close at all times for the system to function

Often suits: those who want the highest level of customisation — pregnant people with type 1 diabetes, athletes, those with highly variable insulin needs, or users who enjoy understanding and engaging with their system.

Omnipod 5 — Iron Man

“Sleek, smart, and the algorithm is already in the suit.”

Omnipod 5 is sleek, wireless, and compact — much like Iron Man’s suits. The SmartAdjust algorithm adjusts insulin delivery every five minutes via micro-bolus, and crucially, the algorithm lives in the Pod itself. The phone or controller is not needed for the automation to work.

The adaptive basal rate that drives SmartAdjust updates automatically based on total daily insulin over the preceding four to five Pods, removing the need for frequent manual setting adjustments.

Like Tony Stark’s technology, it comes at a cost — both financially and in terms of glucose targets. The minimum glucose target is 6.1 mmol/L (110 mg/dL), and the algorithm is designed to be conservative about hypoglycaemia, looking 60 minutes into the future before increasing insulin delivery. For those seeking the tightest possible glucose control, this may limit the achievable time in tight range compared to a well-configured CamAPS FX.

Strengths:

• Tubeless design — discreet and easy to wear
• Highly automated, with minimal required user input; straightforward to set up and use
• Algorithm housed in the Pod — no phone needed for automation to continue

Considerations:

• Minimum glucose target of 6.1 mmol/L (110 mg/dL), combined with the safety-minded algorithm, may limit time in tight range (3.9–7.8 mmol/L / 70–140 mg/dL) compared to some other systems
• May be more expensive than some alternatives for people using more than approximately 70 units per day
• Less customisation available compared to Control-IQ and CamAPS FX

Often suits: children, those new to AID systems, people wanting a simple and effective tubeless system with minimal setup and maintenance.

Putting it all together

Explore each system in depth

• Tandem t:slim X2 with Control-IQ — Spider-Man: detailed guide
• Medtronic 780G — The Incredible Hulk: detailed guide
• CamAPS FX — Batman: detailed guide (see also: CamAPS FX FAQ)
• Omnipod 5 — Iron Man: detailed guide

Other useful AID resources

• GNL AID study day materials
• 10 tips to optimise time in range with AID
• AID and exercise: key guidance
• Looping blind: a DIY perspective
• The six-part AID systems podcast series