Reducing Diabetes Burden Through Algorithmic Automation and GLP-1 Therapy
In this expert conversation, Tugce Akcan, MD, endocrinology fellow at Stanford University, discusses how the use of high-potency GLP-1 receptor agonists—specifically semaglutide and tirzepatide—in combination with the OpenAPS automated insulin dosing algorithm may eliminate the need for meal announcements in individuals with type 1 diabetes. Dr Akcan shares insights into how this approach can reduce disease management burden while maintaining glycemic targets, outlines the real-world data behind the findings, and highlights future directions for research. She presented on this topic at the 2025 American Diabetes Association Scientific Sessions in Chicago, IL.
Additional Resource:
- Akcan T, Kingman RS, Morgan M, Liu Y-T, Kingston K, Lal R. Use of high-potency GLP-1 receptor agonists with OpenAPS automated insulin dosing algorithm eliminates need for meal announcements to achieve glycemic goals. Abstract 944-P. Presented at: American Diabetes Association 85th Scientific Sessions; June 20–23, 2025; Chicago, IL. https://professional.diabetes.org/scientific-sessions
TRANSCRIPTION
Tugce Akcan, MD: My name is Tugce Akcan. I'm an endocrinology fellow at Stanford University, and the presentation I will be given at ADA is Use of High-Potency GLP-1 Receptor Agonists with OpenAPS Automated Insulin Dosing Algorithm Eliminates Need for Meal Announcements to Achieve Glycemic Goals.
Consultant360: What are some of the key themes that you'll be touching on in that presentation?
Dr Akcan: So in this, we explore the use of high-potency GLP-1 receptor agonists—specifically semaglutide and tirzepatide—in combination with the OpenAPS automated insulin delivery algorithm to eliminate the need for meal announcements for people with type 1 diabetes while achieving glycemic targets.
So we focus on a few key themes. The first one is that with proper configuration of the OpenAPS AID system, prandial insulin boluses—or what we call meal announcements—can be eliminated without compromising glycemic control.
This can reduce the cognitive and day-to-day burden of diabetes management, which is a challenge for many people living with type 1 diabetes.
For this study, we used real-world data from individuals using the IAPS and AndroidAPS—these are configurations of the OpenAPS algorithms—with the GLP-1 receptor agonists.
C360: Why do you feel this topic is particularly relevant right now?
Dr Akcan: I think it’s highly relevant because the current commercial AID systems still require meal announcements, which continues to create a burden on users.
Also, the GLP-1 receptor agonists are now more frequently used in people with type 1 diabetes based on their established benefits in other populations and emerging data in type 1 diabetes as well. So it’s highly relevant.
C360: What do you feel are the most important takeaways for clinicians in practice from this presentation?
Dr Akcan: I think the most important takeaway is that in the group of people using the GLP-1 receptor agonists—the high-potency GLP-1 receptor agonists—combined with the OpenAPS AID system, it may allow the safe elimination of meal announcements.
In our cohort, we achieved a time-in-range of nearly 80%, so all participants met the recommended target of 70% or more.
That was without compromising glycemic control. They were able to achieve this, and there were no severe side effects like DKA or severe hypoglycemia, which is reassuring from a safety perspective.
C360: Are there any gaps in knowledge or areas for future research that you would like to see pursued around this topic?
Dr Akcan: Yes. So this is still early-stage work. In our cohort, we included nine individuals.
We definitely need larger studies to confirm these findings and determine which group of people will be most likely to benefit.
But we are encouraged by what we’ve seen so far, so hopefully this study has the potential to meaningfully reduce the burden for type 1 diabetes.