Comparison of Control-IQ and open-source AndroidAPS automated insulin delivery systems in adults with type 1 diabetes: The CODIAC study

Aim: To compare open-source AndroidAPS (AAPS) and commercially available Control-IQ (CIQ) automated insulin delivery (AID) systems in a prospective, open-label, single-arm clinical trial. Methods: Adults with type 1 diabetes who had been using AAPS by their own decision entered the first 3-month AAPS phase then were switched to CIQ for 3 months. The results of this treatment were compared with those after the 3-month AAPS phase. The primary endpoint was the change in time in range (% TIR; 70-80 mg/dL). Results: Twenty-five people with diabetes (mean age 34.32 +/- 11.07 years; HbA1c 6.4% +/- 3%) participated in this study. CIQ was comparable with AAPS in achieving TIR (85.72% +/- 7.64% vs. 84.24% +/- 8.46%; P =.12). Similarly, there were no differences in percentage time above range (> 180 and > 250 mg/dL), mean sensor glucose (130.3 +/- 13.9 vs. 128.3 +/- 16.9 mg/dL; P =.21) or HbA1c (6.3% +/- 2.1% vs. 6.4% +/- 3.1%; P =.59). Percentage time below range (< 70 and < 54 mg/dL) was significantly lower using CIQ than AAPS. Even although participants were mostly satisfied with CIQ (63.6% mostly agreed, 9.1% strongly agreed), they did not plan to switch to CIQ. Conclusions: The CODIAC study is the first prospective study investigating the switch between open-source and commercially available AID systems. CIQ and AAPS were comparable in achieving TIR. However, hypoglycaemia was significantly lower with CIQ.

Automated summary

This study compared open-source AndroidAPS (AAPS) and commercially available Control-IQ (CIQ) automated insulin delivery (AID) systems. The results showed that CIQ and AAPS were comparable in achieving time in range (TIR), but CIQ had a significantly lower rate of hypoglycemia compared to AAPS.