Decision Support Systems and Closed-Loop

The clinical evidence supporting the efficacy and safety of closed-loop systems has accelerated during the last year. Randomized control trials with large number of participants and longer duration of use were published in addition to realworld data including thousands of participants. The accumulative data support the effectiveness and safety of these systems for a large age-range of people with type 1 diabetes. Nevertheless, there is still room for further improvement in glycemic control, and there is a need to continue searching for strategies and adjuvant therapy to overcome postprandial hyperglycemia and exercise-induced hypoglycemia. Automated insulin delivery systems are now available for people with type 1 diabetes. Clinical guidelines for starting, using, and follow-up of these systems are needed and are under preparation by several groups. Advocacy efforts are required to make closed-loop systems accessible for all people with diabetes to eliminate disparities in diabetes quality of care. DECISION SUPPORT SYSTEMS AND CLOSED-LOOP S-73 Another important breakthrough was the first randomized control trial (the Advisor Pro study) demonstrating that an algorithm can be fed with human intelligence and provide same quality of care as experienced endocrinologists. This enables remote access of quality diabetes care, an ability that was found to be especially valuable duringthe current COVID-19 outbreak. The increased use of technology provides an abundance of valuable diabetes-related data. These data must be linked to decision support systems that can process and analyze the data to provide actionable personalized therapeutic recommendations.