Use of High-Potency GLP-1 Receptor Agonists With OpenAPS Automated Insulin Dosing Algorithm Eliminates Need for Meal Announcements to Achieve Glycemic Goals

Type 1 diabetes requires continuous self-management, including careful attention to insulin dosing, food intake, and daily activities.Automated insulin delivery (AID) systems integrate insulin pumps, continuous glucose monitors (CGMs), and control algorithms to adjust insulin dosing in real time, improving glycemic outcomes and quality of life compared with traditional therapy (1).All commercially available AID systems require manual meal announcements, which adds burden and contributes to missed boluses and suboptimal realworld glycemic control (2).A fully automated system capable of handling unannounced meals (UAM) would meaningfully reduce treatment burden.Open-source AID (OS-AID) algorithms are publicly accessible, allowing users and clinicians to fully understand, customize, and manage these systems.Instructions for setup and use are freely available online, and tens of thousands of people with diabetes currently use OS-AID systems worldwide.Their use has been supported by computer simulations, animal studies, observational studies, and randomized clinical trials (3).OpenAPS is one such open-source algorithm, developed by Dana Lewis and Scott Leibrand and publicly shared since 2015.It has since evolved through the hard work of the open-source diabetes community and been implemented on Android as AndroidAPS and on iOS as iAPS and Trio.OpenAPS can integrate with a range of CGMs and insulin pumps and is currently the only AID platform capable of supporting UAM (4).High-potency glucagon-like peptide 1