barely_stubbell

Even a reduction in the amount of hypo- (and, hyper-) glycemic events would be a big win for patients and educators. I think the quality of care would vastly increase with such systems in place.

Additionally - the human body has systems in place to bring blood sugars back into a safe range when it feels it is in an emergency situation. I do not claim to be an expert on this matter, but it is my understanding that the liver is able to release glycogen into the system to spike blood glucose levels back up if they have fallen low [1]. This is why some diabetic patients may experience high blood sugars in the mornings if they have experienced a hypoglycemic event overnight and slept through it. I don't believe this would be a good solution to depend on, however.

New pumps by Medtronic are equipped with an auto-off feature that suspends insulin delivery if the user's blood sugar is below a certain threshold [1], however this is a rear-facing indicator and the patient will still experience a hypoglycemic event.

I assume the next logical steps towards making these systems fully autonomous is to remove the idealogical separation of basal and bolus insulin; instead, the system would register increases and decreases of blood sugar and take systematic steps towards bringing them back into a healthy range - much like a healthy pancreas does, either by increasing or decreasing the amount of insulin being delivered at a given time. That way a patient can eat, exercise, and live a "normal" lifestyle while the pump takes care of delivering the correct amount of insulin.