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AndroidAPS

Open-source community (AndroidAPS project)

What it is

A mature open-source automated insulin delivery app for Android, built on the OpenAPS/oref algorithm. Among the most advanced and tunable DIY loops — with Super Micro Bolus, automatic sensitivity (Autosens), and dynamic ISF — and an open-source system whose algorithm has been validated in a published randomized controlled trial.

Editorial review: .

Source dates appear in the references where available; this record has no dated citation metadata.

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Evidence behind this assessment

Key evidence notes. Study results, product eligibility and access answer different questions.

Who was studied?
Study populations and analysis groups vary. Product age limits alone do not describe who was studied.See the linked studies and their populations →
Benefit or performance
Algorithm sophistication: OpenAPS/oref1 lineage with Super Micro Bolus, Autosens auto-sensitivity, and dynamic ISF; the CREATE randomized trial showed this algorithm raised time-in-range by 14 percentage points versus a sensor-augmented pump.Read the supporting discussion; this assessment has no individually linked citation.
Important harms and treatment burden
Read the safety discussion and original sources. A missing summary does not establish safety.
Approval and country access
Country-specific approval and access are not summarized in this record.Approval, trial recruitment, local supply and funding are separate. Check the cited label or access source.
Follow-up and remaining uncertainty
Read the full discussion and original sources for follow-up duration and study limitations.
Editorial score: calculation and evidence

A weighted editorial judgment on a 0–100 scale, not a probability of success or a measured treatment effect. Higher criterion scores mean more favorable assessments.

Default calculation: 90 × 25 + 80 × 20 + 95 × 20 + 88 × 15 + 40 × 20 = 7870; divide by total weight 100. Unrounded weighted result: 78.7.

Algorithm sophistication90

OpenAPS/oref1 lineage with Super Micro Bolus, Autosens auto-sensitivity, and dynamic ISF; the CREATE randomized trial showed this algorithm raised time-in-range by 14 percentage points versus a sensor-augmented pump.

Hardware support80

Broad, growing pump roster (Dana, Accu-Chek Insight/Combo, Omnipod DASH/Eros, Medtrum, Diaconn, EOPatch, Equil) plus Dexcom, FreeStyle Libre and Eversense glucose sources — wider than most DIY loops, but Android-only and limited to a specific compatibility list.

Customizability95

Every parameter is inspectable and tunable and the source is fully open — the defining advantage of the system, enabling individualization commercial AID does not allow.

Community & docs88

Large multinational user base (an 897-user survey spanned 35 countries), extensive maintained documentation, and a structured objectives-based onboarding with active community support.

Ease of setup40

Cannot be downloaded ready-made: users must self-compile the app in Android Studio, then progress sequentially through 10 objectives (closed loop and SMB unlock progressively, with SMB at objective 9) — far more effort than a commercial system.

The full picture

AndroidAPS (AAPS) is a free, open-source automated insulin delivery (AID) app — an "artificial pancreas system" — that runs on Android smartphones and uses an OpenAPS software algorithm to automate insulin dosing.1 There is no iOS version of AAPS; the separate open-source Loop app is the iPhone-side counterpart (comparison per project-docs scope, not an explicitly fetched sentence in this review). AAPS pairs a phone, a continuous glucose monitor (CGM), and a compatible insulin pump into a closed loop.1

Algorithm and sophistication. AAPS implements the OpenAPS "oref" algorithm. Its most advanced mode, oref1, adds Super Micro Bolus (SMB) — frequent tiny correction boluses instead of only temporary basal rates — introduced in 2018.2 It also offers Autosens, which infers how sensitive or resistant you currently are from glucose deviations and adjusts basal and ISF accordingly, and DynamicISF, which is described as continuously rescaling insulin sensitivity from total daily dose and predicted glucose (feature-doc detail; DynamicISF page not re-verified in this review).32 The project presents this as making its handling of changing sensitivity and partly-announced or unannounced meals among the most capable of any loop (comparative characterization; no head-to-head comparison fetched).

Supported hardware. AAPS supports an unusually broad pump list for a DIY system: Dana R/RS/-i, Accu-Chek Insight and Combo, Omnipod DASH and Eros, Medtrum Nano/300U, Diaconn G8, EOPatch2, Equil, and certain older Medtronic models (the last two reported to need an extra relay device; specifics not found verbatim in the pages read).4 CGM sources include Dexcom (G5/G6/G7; G5 not found verbatim in the pages read), FreeStyle Libre 2/3, and Eversense, mostly routed through the companion xDrip+ app.5

Customizability, community, docs. Because the code is open, every parameter is inspectable and tunable — the defining advantage over commercial AID, which cannot be individualized to the same degree.6 AAPS has users worldwide; a multinational survey of open-source AID users drew 897 respondents across 35 countries.7 Documentation is extensive and maintained on a public ReadTheDocs site.1

Setup complexity and legal status. AAPS cannot simply be downloaded: for legal and safety reasons users must build (compile) the app themselves in Android Studio.1 After installing, you must complete 10 sequential "objectives" — open loop, low-glucose-suspend, then closed loop and SMB unlock progressively, with SMB at objective 9.8 The project states plainly that it is for informational/educational use, carries no warranty or manufacturer endorsement, and is used "at your own risk."1 AAPS is not a regulator-approved medical device; in 2019 the U.S. FDA warned against unauthorized diabetes devices, including do-it-yourself automated insulin dosing systems, described as citing risks of unsafe dosing (warning-body detail per the cited release; body not re-verified in this review).9 That FDA warning is still the operative regulatory position. The professional-guideline position, though, is different — and more supportive. The American Diabetes Association's Standards of Care in Diabetes—2026 (Section 7, published December 2025) is cited as recommending, at grade B, that clinicians "support and provide diabetes management advice to people with diabetes who choose to use an open-source AID system" (recommendation 7.27 as cited; reported to match the 2025 Standards' 7.29).10 The ADA is explicit that open-source AID — its preferred term is OS-AID — is still not regulator-approved; the recommendation is about not abandoning the people who use it. Responsibility that commercial support would carry still falls on the user.

Clinical evidence. The AAPS/OpenAPS algorithm was tested in a randomized controlled trial. The CREATE trial (NEJM, 2022) randomized 97 children and adults to a modified AndroidAPS 2.8 + OpenAPS 0.7.0 system (DANA-i pump, Dexcom G6) versus a sensor-augmented pump; time-in-range rose from 61.2% to 71.2% with AID — an adjusted 14-point benefit (about 3 hours 21 minutes more per day in range), with no severe hypoglycemia or ketoacidosis in either arm.11 A 24-week continuation phase confirmed durable benefit across pump types and ages over 48 weeks.12 Large observational datasets agree: a pediatric survey and a multinational adult/caregiver survey both reported significant HbA1c and time-in-range improvements after starting open-source AID.137

Real-world follow-up continues to support this, though the newer studies are small. According to PubMed, a one-year single-centre observational study of 27 adults starting AAPS reported time-in-range rising from 67.8% to 84.1% at six months and settling at 79.9% at twelve, with HbA1c falling from 6.6% to 6.1% at six months and 6.0% at twelve, and no severe hypoglycemia or ketoacidosis.14 In 55 children and adolescents aged 6–19 using AAPS, glycemic outcomes were no different between school days and holidays — a practical reassurance that the system holds up through disrupted routines — and longer night-time sleep was associated with more time in range (association as reported in the paper; not re-verified against a fetched passage in this review).15 Both are observational, single-cohort studies, not trials.

What's coming. Development is continuous and community-driven rather than tied to a release cycle. The current release is 3.4.2.6 (2 August 2026), following three rapid maintenance releases since July; 3.4.2.4 fixed Equil and Nightscout profile synchronization, 3.4.2.5 fixed an Equil race condition, and 3.4.2.6 further improved Equil stability (per-release detail per the project's release notes; only the 3.4.2.6 tag record was re-verified in this review).16 The 3.4 line is also described as having matured DynamicISF and a Full Closed Loop mode that reduces meal announcements, with broadened pump support (feature-doc status; pages not re-verified in this review).34 These are maintenance changes, not evidence that Omnipod 5 support has shipped.

Two things worth knowing if you are comparing AAPS with its cousins. First, Omnipod 5: community work to drive the Omnipod 5 pod from open-source loops is underway, but it is further along in Loop and Trio — Trio 1.0 has shipped and Omnipod 5 support is in open beta for Loop and Trio users, with AndroidAPS support still in development and no ETA (Loop release numbering unconfirmed in the sources read).17 A developer interview reported at D-Data/ADA 2026 suggested broader AAPS usability in late 2026 or early 2027, but that is a journalist's report of a conversation, not a project commitment, and no AAPS beta is confirmed in the sources read.18 Second, Auto-ISF: the Auto-ISF settings that iAPS and Trio users talk about are not part of official AndroidAPS. Auto-ISF lives only as a third-party community fork built on top of AAPS; the official app ships DynamicISF instead.19

Glucose values: time-in-range target is 70–180 mg/dL (3.9–10.0 mmol/L).

September release check. Official AndroidAPS remains 3.4.2.6. Trio 1.0 has shipped and Omnipod 5 support is in open beta for Loop and Trio users; those releases do not imply AndroidAPS compatibility (Loop release numbering unconfirmed).20

What's next for this

  • →Omnipod 5 pod support (community work; at an earlier stage than in Loop and Trio, where open-beta support is reported — nothing has shipped for AndroidAPS) · No ETA from the project; one developer interview suggested broader usability in late 2026 – early 2027

Sources

  1. [1]

    AndroidAPS project. Welcome to the AndroidAPS documentation (platform, OpenAPS algorithm, required components, build-it-yourself requirement, and risk/no-warranty disclaimer). AndroidAPS ReadTheDocs (accessed 2026). https://androidaps.readthedocs.io/en/latest/index.html

  2. [2]

    AndroidAPS project. OpenAPS features — Super Micro Bolus (SMB), an oref1 feature introduced from 2018. AndroidAPS ReadTheDocs (accessed 2026). https://androidaps.readthedocs.io/en/latest/Usage/Open-APS-features.html

    AndroidAPS project. OpenAPS features — Autosens sensitivity detection. AndroidAPS ReadTheDocs (accessed 2026). https://androidaps.readthedocs.io/en/latest/Usage/Open-APS-features.html

  3. [3]

    AndroidAPS project. DynamicISF (DynISF) — dynamic insulin sensitivity from total daily dose and predicted glucose. AndroidAPS ReadTheDocs (accessed 2026). https://androidaps.readthedocs.io/en/latest/DailyLifeWithAaps/DynamicISF.html

  4. [4]

    AndroidAPS project. Compatible Pumps. AndroidAPS ReadTheDocs (accessed 2026). https://androidaps.readthedocs.io/en/latest/Getting-Started/CompatiblePumps.html

  5. [5]

    AndroidAPS project. Compatible CGMs / glucose sources (Dexcom, FreeStyle Libre, Eversense via xDrip+). AndroidAPS ReadTheDocs (accessed 2026). https://androidaps.readthedocs.io/en/latest/Getting-Started/CompatiblesCgms.html

  6. [6]

    Burnside MJ, Lewis DM, Crocket HR, et al. CREATE trial protocol — open-source algorithms allow individualisation of algorithm parameters, unlike commercial AID. J Diabetes Metab Disord (2020). https://pubmed.ncbi.nlm.nih.gov/32837953/

  7. [7]

    Braune K, Gajewska KA, Thieffry A, et al. Why #WeAreNotWaiting — motivations and self-reported outcomes among users of open-source AID: multinational survey (897 respondents, 35 countries; HbA1c 7.14%→6.24%, TIR 63.0%→80.3%). J Med Internet Res (2021). https://doi.org/10.2196/25409

  8. [8]

    AndroidAPS project. Completing the Objectives — 11 sequential objectives; closed loop and SMB unlock progressively. AndroidAPS ReadTheDocs (accessed 2026). https://androidaps.readthedocs.io/en/latest/SettingUpAaps/CompletingTheObjectives.html

  9. [9]

    U.S. Food and Drug Administration. FDA warns against the use of unauthorized devices for diabetes management (including do-it-yourself automated insulin dosing systems). FDA (2019). https://www.fda.gov/news-events/press-announcements/fda-warns-against-use-unauthorized-devices-diabetes-management

  10. [10]

    American Diabetes Association Professional Practice Committee. 7. Diabetes Technology: Standards of Care in Diabetes—2026 (recommendation 7.27, grade B: "Support and provide diabetes management advice to people with diabetes who choose to use an open-source AID system"). Diabetes Care 2025 Dec 8;49(Suppl 1):S150–S165. https://doi.org/10.2337/dc26-S007

  11. [11]

    Burnside MJ, Lewis DM, Crocket HR, et al. Open-Source Automated Insulin Delivery in Type 1 Diabetes (CREATE randomized controlled trial). N Engl J Med 2022;387(10):869-881. https://pubmed.ncbi.nlm.nih.gov/36069869/

  12. [12]

    Burnside MJ, Lewis DM, Crocket HR, et al. Extended Use of an Open-Source Automated Insulin Delivery System: the 24-week continuation phase following CREATE (48 weeks total; treatment effect +12.2% TIR, no DKA or severe hypoglycemia). Diabetes Technol Ther 2023;25(4):250-259. https://pubmed.ncbi.nlm.nih.gov/36763345/

  13. [13]

    Braune K, O'Donnell S, Cleal B, et al. Real-world use of do-it-yourself artificial pancreas systems in children and adolescents: online survey (209 caregivers, 21 countries; HbA1c 6.91%→6.27%, TIR 64.2%→80.7%). JMIR Mhealth Uhealth (2019). https://doi.org/10.2196/14087

  14. [14]

    Amuedo S, Antequera-González M, Azriel S. Glycemic outcomes with an open-source automated insulin delivery system in adults with type 1 diabetes: a 1-year real-world observational study (27 adults on AndroidAPS; TIR 67.8%→84.1% at 6 months, 79.9% at 12 months; HbA1c 6.6%→6.1%→6.0%; no severe hypoglycemia or DKA). According to PubMed. Diabetes Technol Ther 2026;28(7):739-745. https://pubmed.ncbi.nlm.nih.gov/41566695/

  15. [15]

    Li X, Ye X, Tang J, et al. Glycaemic control during school days and holidays in children and adolescents with type 1 diabetes using open-source Android artificial pancreas systems (55 participants aged 6–19; no significant difference between school days and holidays). According to PubMed. Diabetes Obes Metab (2026). https://pubmed.ncbi.nlm.nih.gov/42348355/

  16. [16]

    AndroidAPS project. Release notes for 3.4.2.6 (2 August 2026), following 3.4.2.4 on 22 July and 3.4.2.5 on 30 July; maintenance fixes for Equil stability/race conditions and Nightscout profile synchronization. https://github.com/nightscout/AndroidAPS/releases/tag/3.4.2.6

  17. [17]

    Nightscout / open-source AID community. Omnipod 5 — open-source AID (open beta listed for Loop and Trio; AndroidAPS support in development, no ETA). nightscout.github.io (accessed 2026-07-02). https://nightscout.github.io/omnipod-five/

  18. [18]

    Diabetech. Omnipod 5 and Tandem Mobi support headed to Loop, Trio and AAPS — developer interview; AAPS at an earlier stage, broader usability suggested for late 2026 / early 2027. Diabetech (2026-06-09). https://www.diabetech.info/p/omnipod-5-and-tandem-mobi-support-headed-to-loop-trio-and-aaps

  19. [19]

    ga-zelle. autoISF — an AndroidAPS extension for specific glucose behaviours; a third-party fork built on AAPS v3.4.0, not part of the official app. GitHub (live-checked 27 August 2026). https://github.com/ga-zelle/autoISF

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