It would be nice if there was some kind of a box that that you could just turn on and it would completely solve a problem, something like Tesla’s completely autonomous cars or a truly artificial pancreas.
But there isn’t, and they’re never will be. Nothing physical is eternal or can be 100 percent reliable.
Good BG management requires awareness, data and comprehension. Asking questions about failure modes is a good start.
No blood glucose measurement system is trustworthy and reliable, not A1c tests, CGMs or fingerstick glucometers. Of those three, the fingerstick is the more reliable for making management decisions, IF it is used properly.
No automatic pump system is a substitute for a person with diabetes intelligently managing their blood glucose. These are tools. The best experimental pump makes it possible to improve the BG management of a poorly managed PWD but not the BG of an expert manager using more basic tools.
A hybrid closed loop system is designed to TRY TO keep BG in a defined range. It is ineffective in bringing BG into that range from above it or below it. A CGM becomes increasingly inaccurate outside of that range while a finger stick meter continues to work better.
The PWD always has to be ready to assume control using positive glucose or negative insulin correction, exactly the same as with MDI.
With a hybrid closed loop system, an inaccurate sensor reading is handled with a finger stick reading when a meal bolus is given. When confirmed that a high or low CGM is far off, a fingerstick reading is used to calibrate the system and calculate a correction.
With all that being said, I prefer using a CGM and pump to fingersticks and MDI but not because it’s simpler or more accurate. It’s neithe
It is an assistant that can be trusted within limits to alert me when something goes very wrong and to let me know in what direction things are changing. Within those limits it can make simple decisions and report to me what it’s done.
I’m still the boss, I still have to make the hard and strategic decisions. I still have to pay the bills make sure that the stock is an inventory and it’s used properly. I have to know how to run my business and I need to be able to tell when something isn’t working right.
Over time I expect the newer “assistants” that I use to become better and to delegate more things to them, as I already do calculations for boluses and corrections.
But I’d be foolish to ever believe that anything is reliable when it depends on software and small parts. Or that it cares about preserving my life.