Insulin can be delivered by injections or pump:

1-injections contain certain amount of insulin to be injected according calculations (manual dosing)

2- pumps deliver insulin continuously under the skin-actually mimicking the response of healthy pancreas leads to optimum glycemic control :

pumps could batch pump  or traditional pump:


  1.  traditional pump uses a fine tube to connect the pump to the cannula. The pump is worn in the pocket.  The program controls are on the pump.
  2. A patch pump has a small tube or no tube, and the pump is stuck to the skin. The controls are on a separate wireless device.: Equil : example of new patch insulin pump.produced also by glucoRx                    
  3. constant amount of insulin is needed all the the time in addition to various shots according glucose rise .

glucose sensing and giving insulin accordingly is called  closed loop system where CGM talks to pump and provide with glucose updates.

previously-open loop system was developed  where pump -completely-programmed  by the users and according to blood glucose level measured by a glucometer or CGM . (there  is a separate sensor for monitoring)

Recently,closed loop appeared where a pump is connected to a CGM and both are talking to each other (glucose sensed is the output which will be considered as a feedback in order to adjust the initial input: this is the main difference between open loop and closed loop control system:  closed loop vs open loop

however, sub optimal accuracy of available sensors remains an obstacle  towards developing of a complete closed loop system where insulin (basal or bolus )is administered automatically

Till now a hybrid closed loop  (HCL)system is the only developed  and approved where a a basal insulin only can be delivered  according to CGM readings while bolus is not . (manual intervention is still needed )

HCL is the initial  outcome  of artificial pancreas research where a bright future of diabetes  management is about to be realized. 

at the end, TOP needs to be highlighted which (DIY) project (not approved by any organization still under trial)

TOP is a fully closed loop system depends on auto piloting where a continuous review of previous days are performed to double check the impact of insulin dosing in addition to certain tactics of supervised machine learning . see :


Ypsomed insulin pump: