Open-source automated insulin delivery systems in children and adolescents

This article discusses the development and use of open-source automated insulin delivery (AID) systems for children and adolescents with diabetes. These technologies provide much-needed alternatives to commercial products, particularly if approved systems are unavailable or insufficiently adapted to the specific needs of the user. Open-source AID systems such as Loop, OpenAPS, AndroidAPS, and iAPS are developed by a committed society of persons with diabetes and their relatives. They offer do-it-yourself approaches to personalized diabetes treatment based on available insulin pumps and systems for continuous glucose monitoring. Recent studies have demonstrated that both commercial and open-source AID systems enhance clinical outcomes and quality of life. Despite the lack of regulatory approval in Europe, these systems represent an effective treatment option for children and adolescents with diabetes, underscored by many positive experiences in clinical practice and users' everyday life. The article also addresses the ethical and legal challenges of employing open-source technologies in pediatric diabetology. Despite the challenges associated with using medical software without regulatory clearance, well-informed and well-supported application of these systems can deliver effective results. The article stresses the importance of collaboration among people with diabetes, their families, and medical professionals to ensure the success and safely of treatment and to boost the empowerment and autonomy of persons with diabetes.