Article section
The Automated Insulin Delivery System in Nigeria: Advances, Challenges, And Future Prospects in Closed-Loop Insulin Delivery Systems
Abstract
Despite the advancements that have been made in other countries regarding care and management, Diabetes Mellitus remains a serious concern to the public in Nigeria; its prevalence keeps increasing, and modern care methods remain inaccessible. The invention of the automated insulin delivery system is an approach that seems hopeful for enhancing glycemic control. However, adopting it in Nigeria is disadvantaged by high cost, inadequate health care facilities, and even the patients. This review mainly focuses on the important perceptions regarding the management of diabetes in Nigeria’s health care, such as the handiness and approachability of Continuous Glucose Monitors (CGMs) and insulin pumps. Economic limitations, technological backwardness, and gaps in regulation are all major factors contributing to the problem in the adoption automated insulin delivery system. We strongly recommend local manufacturing of low-cost diabetic equipment, governmental changes to improve access and incorporate the automated insulin delivery system into the healthcare programs, and collaboration between public and private health sectors to improve access and make these modern care methods affordable for diabetes patients. Future directions should be focused on manufacturing low-cost, AI-driven diabetes equipment for managing diabetes and should be tailored to the needs of Nigeria’s health care. Policymakers should focus primarily on providing insurance that covers these technology-driven treatment plans, efforts should be made to provide adequate training to healthcare professionals, and sensitization programs to inform patients. By doing these, Nigeria can advance to incorporating an automated insulin delivery system into diabetes care, positively impacting patient outcomes and quality of life.
Keywords:
Automated Insulin Delivery System Continuous Glucose Monitoring (CGM) Diabetes Management Health Technology Access Nigeria Healthcare
Article information
Journal
Journal of Medical Science, Biology, and Chemistry
Volume (Issue)
2(1), (2025)
Pages
64-74
Published
Copyright
Copyright (c) 2025 Olabisi Promse Lawal, Aransiola Favour Taiye, Chibuike Emmanuel Okafor, Kelechi Wisdom Elechi, Enibokun Theresa Orobator, Toluwanimi Janet Kolapo, Aliyu Olanrewaju Olaniyi, Madhumati Mandal, Happiness Ifedolapo Olaniyi (Author)
Open access

This work is licensed under a Creative Commons Attribution 4.0 International License.
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References
Ajayi, I. O., Balogun, W. O., Olopade, O. B., Ajani, G. O., Soyoye, D. O., Bolarinwa, O. A., Olamoyegun, M. A., Alatishe-Muhammad, B. W., Odeniyi, I. A., Odukoya, O., Fasanmade, O. A., Diyaolu, F. P., Otrofanowei, E., Akase, I., Agabi, P. O., Adejimi, A., Ajetunmobi, O. A., Durowade, K. A., Gabriel-Alayode, E. O., … Nasiru, S. (2023). Prevalence of haemoglobin A1c based dysglycaemia among adult community dwellers in selected states in Nigeria: A descriptive cross-sectional study. Frontiers in Endocrinology, 14, 1192491. https://doi.org/10.3389/fendo.2023.1192491
Al-Naseem, A. O., Attia, A., Gonnah, A. R., Al-Naseem, A. O. A. S., Spiers, H. V. M., Gruessner, A., Leelarathna, L., Thabit, H., & Augustine, T. (2023). Pancreas transplantation today: Quo vadis? European Journal of Endocrinology, 188(4), R73–R87. https://doi.org/10.1093/ejendo/lvad032
CHAI. (2021). Diabetes Self-Monitoring Devices in LMICs [Market Report]. Clinton Health Access Initiative.
Chukwu, N., Agwu, P., Ajibo, H., & Aronu, N. (2022). Challenges faced by informal caregivers of patients in a Nigerian hospital and implications for social work. Journal of Social Work, 22(5), 1189–1206. https://doi.org/10.1177/14680173221077371
Dermawan, D., & Kenichi Purbayanto, M. A. (2022). An overview of advancements in closed-loop artificial pancreas system. Heliyon, 8(11), e11648. https://doi.org/10.1016/j.heliyon.2022.e11648
Emmanuel O., O., Mfonobong F., A., Koofreh G., D., & Musiliu O., A. (2021). Advances in the science and technology of insulin delivery: A review. Journal of Applied Pharmaceutical Science, 11(08), 184-191. https://doi.org/10.7324/JAPS.2021.110824
GBN. (2023). NAFDAC excited by first Nigerian company producing glucometer. General News. https://gbn.com.ng/nafdac-exited-by-first-nigerian-company-producing-glucometer/
Haidar, A., Tsoukas, M. A., Bernier-Twardy, S., Yale, J.-F., Rutkowski, J., Bossy, A., Pytka, E., El Fathi, A., Strauss, N., & Legault, L. (2020). A Novel Dual-Hormone Insulin-and-Pramlintide Artificial Pancreas for Type 1 Diabetes: A Randomized Controlled Crossover Trial. Diabetes Care, 43(3), 597–606. https://doi.org/10.2337/dc19-1922
Ibrahim, A. O., Agboola, S. M., Elegbede, O. T., Ismail, W. O., Agbesanwa, T. A., & Omolayo, T. A. (2021). Glycemic control and its association with sociodemographics, comorbid conditions, and medication adherence among patients with type 2 diabetes in southwestern Nigeria. Journal of International Medical Research, 49(10), 03000605211044040. https://doi.org/10.1177/03000605211044040
IDF. (2021). IDF DIabetes Atlas. International Diabetes Foundation. https://diabetesatlas.org/atlas/tenth-edition/
Kadiyala, N., Hovorka, R., & Boughton, C. K. (2024). Closed-loop systems: Recent advancements and lived experiences. Expert Review of Medical Devices, 21(10), 927–941. https://doi.org/10.1080/17434440.2024.2406901
Kapil, S., Saini, R., Wangnoo, S., & Dhir, S. (2020). Artificial pancreas system for type 1 diabetes—challenges and advancements. Exploratory Research and Hypothesis in Medicine, 5(3), 110-120. https://doi.org/10.14218/ERHM.2020.00028
Kesavadev, J., Krishnan, G., & Mohan, V. (2021). Digital health and diabetes: Experience from India. Therapeutic Advances in Endocrinology and Metabolism, 12, 20420188211054676. https://doi.org/10.1177/20420188211054676
Kiconco, R., Lumumba, S. A., Bagenda, C. N., Atwine, R., Ndarubweine, J., & Rugera, S. P. (2024). Insulin therapy among diabetic patients in rural communities of Sub-Saharan Africa: a perspective review. Therapeutic Advances in Endocrinology and Metabolism, 15, 20420188241232280.
Lal, R. A., Ekhlaspour, L., Hood, K., & Buckingham, B. (2019). Realizing a Closed-Loop (Artificial Pancreas) System for the Treatment of Type 1 Diabetes. Endocrine Reviews, 40(6), 1521–1546. https://doi.org/10.1210/er.2018-00174
Manson, E. N., Hasford, F., Trauernicht, C., Ige, T. A., Inkoom, S., Inyang, S., Samba, O., Khelassi-Toutaoui, N., Lazarus, G., Sosu, E. K., Pokoo-Aikins, M., & Stoeva, M. (2023). Africa’s readiness for artificial intelligence in clinical radiotherapy delivery: Medical physicists to lead the way. Physica Medica, 113, 102653. https://doi.org/10.1016/j.ejmp.2023.102653
Mercer, T., Chang, A. C., Fischer, L., Gardner, A., Kerubo, I., Tran, D. N., Laktabai, J., & Pastakia, S. (2019). Mitigating The Burden Of Diabetes In Sub-Saharan Africa Through An Integrated Diagonal Health Systems Approach. Diabetes. Metabolic Syndrome and Obesity: Targets and Therapy, 12, 2261–2272. https://doi.org/10.2147/DMSO.S207427
Mesko, B. (2016). The Medical Futurist. What Is Living With An Artificial Pancreas Like? https://medicalfuturist.com/living-with-an-artificial-pancreas/
Modibbo, M. R., Ibrahim, H., Sulaiman, M. Y., & Zakir, B. (2024). Maganin Gargajiya: Assessing the Benefits, Challenges, and Evidence of Traditional Medicine in Nigeria. Cureus. https://doi.org/10.7759/cureus.71425
Mohamed, H., El Sayed, S., & Mahmoud, D. (2024). Effect of Educational Guidelines on Diabetic Patients’ Knowledge, Attitude, and Self-Efficacy Regarding Use of Artificial Pancreas. Evidence-Based Nursing Research, 6(3), 32–40. https://doi.org/10.47104/ebnrojs3.v6i3.338
Mohammed, A., Kafayat, S., Adam, A. A., Zango, M. S., Hassan, A., Dandago, K. K., & Abubakar, A. N. (2022). Towards the Development of a Low-Cost Artificial Pancreas: A Solution to Type-1 Diabetes in Sub-Saharan Africa. FUW Trends in Science & Technology Journal, 7(2), 911–918.
Moshood, T. D., Sorooshian, S., Nawanir, G., & Okfalisa, S. (2022). Efficiency of medical technology in measuring service quality in the Nigerian healthcare sector. International Journal of Africa Nursing Sciences, 16, 100397. https://doi.org/10.1016/j.ijans.2022.100397
Mukamurera, P. N. (2024). Technological Innovations in the Management of Gestational Diabetes in Nigeria. Idosr journal of biology, chemistry and pharmacy, 9(3), 5–10. https://doi.org/10.59298/IDOSR/JBCP/24/93.51000
Neha, G., & Saurahb, V. (2024). Technological advancements in glucose monitoring and artificial pancreas systems for shaping diabetes care. Current Medical Research and Opinion, 4(12), 2095–2107. https://doi.org/10.1080/03007995.2024.2422005
Nkpozi, M. O., Bozimo, G., Ubani, B., Owolabi, F., Akhidue, K., Ezeude, C., & Ogbonna, S. (2022). Insulin initiation in Type 2 diabetes mellitus outpatients – data from the multicentre evaluation of type 2 diabetes mellitus outpatients on insulin therapy in Nigeria (METOIN study). Journal of Drug Delivery and Therapeutics, 12(6), 120–123. https://doi.org/10.22270/jddt.v12i6.5810
Ogbera, A. O. & Ekpebegh, Chukwuma. (2014). Diabetes mellitus in Nigeria: The past, present and future. World Journal of Diabetes, 5(6), 905. https://doi.org/10.4239/wjd.v5.i6.905
Oguoma, V. M., Nwose, E. U., & Richards, R. S. (2015). Prevalence of cardio-metabolic syndrome in Nigeria: A systematic review. Public Health, 129(5), 413–423. https://doi.org/10.1016/j.puhe.2015.01.017
Ogurtsova, K., Guariguata, L., Barengo, N. C., Ruiz, P. L.-D., Sacre, J. W., Karuranga, S., Sun, H., Boyko, E. J., & Magliano, D. J. (2022). IDF diabetes Atlas: Global estimates of undiagnosed diabetes in adults for 2021. Diabetes Research and Clinical Practice, 183, 109118. https://doi.org/10.1016/j.diabres.2021.109118
Okoronkwo, I. L., Ekpemiro, J. N., Okwor, E. U., Okpala, P. U., & Adeyemo, F. O. (2015). Economic burden and catastrophic cost among people living with type2 diabetes mellitus attending a tertiary health institution in south-east zone, Nigeria. BMC Research Notes, 8(1), 527. https://doi.org/10.1186/s13104-015-1489-x
Okubanjo, A. A., Alexander, O., Olumide, O., Benjamin, A., & Oluwatoyin, O. (2024). Development of a low-cost IoT-based e-health monitoring system for diabetic patients. Journal of Electrical Systems and Information Technology, 11(1), 54. https://doi.org/10.1186/s43067-024-00178-6
Oladipo, E. K., Adeyemo, S. F., Oluwasanya, G. J., Oyinloye, O. R., Oyeyiola, O. H., Akinrinmade, I. D., Elutade, O. A., Areo, D. O., Hamzat, I. O., Olakanmi, O. D., Ayanronbi, I. I., Akanmu, A. J., Ajekiigbe, F. O., Taiwo, M. O., Ogunfidodo, V. M., Adekunle, C. A., Adeleke, P. O., Olubunmi, D. A., Adeogun, P. A., … Nnaji, N. D. (2024). Impact and Challenges of Artificial Intelligence Integration in the African Health Sector: A Review. Trends in Medical Research, 19(1), 220–235. https://doi.org/10.3923/tmr.2024.220.235
Olatunde, O. I. (2025). Evaluating the challenges and opportunities for diabetes care policy in Nigeria. Open Health, 6(1), 20230056. https://doi.org/10.1515/ohe-2023-0056
Onyedika-Ugoeze, N. & Nwanosike, I. (2024, October 31). Nigeria may suffer five million diabetes cases by 2030, warns IDF. The Guardian. https://guardian.ng/news/nigeria-may-suffer-five-million-diabetes-cases-by-2030-warns-idf/
Patel, P. M., Thomas, D., Liu, Z., Aldrich‐Renner, S., Clemons, M., & Patel, B. V. (2024). Systematic review of disparities in continuous glucose monitoring and insulin pump utilization in the United States: Key themes and evidentiary gaps. Diabetes, Obesity and Metabolism, 26(10), 4293–4301. https://doi.org/10.1111/dom.15774
Quintal, A., Messier, V., Rabasa-Lhoret, R., & Racine, E. (2019). A critical review and analysis of ethical issues associated with the artificial pancreas. Diabetes & Metabolism, 45(1), 1–10. https://doi.org/10.1016/j.diabet.2018.04.003
Sosale, B., & Sosale, A. (2016). Modulation of Metabolic Parameters and Antioxidant Enzymes in Diabetic Aging Female Rat Brain: Beneficial Role of Metformin.
Thabit, H., & Hovorka, R. (2015). The Future of the Artificial Pancreas. Diabetes Technology & Therapeutics, 17(11), 763–765. https://doi.org/10.1089/dia.2015.0297
Ubalaeze S, E., Kelechi W, E., Erere G, O., Chinemerem D, A., & Chioma S, N. (2024). The Impact of Digital Transformation on Healthcare Delivery in Nigeria: Challenges and Recommendations. International Journal of Research and Scientific Innovation, XI(XV), 498–509. https://doi.org/10.51244/IJRSI.2024.11150035P
Uloko, A. E., Musa, B. M., Ramalan, M. A., Gezawa, I. D., Puepet, F. H., Uloko, A. T., Borodo, M. M., & Sada, K. B. (2018). Prevalence and Risk Factors for Diabetes Mellitus in Nigeria: A Systematic Review and Meta-Analysis. Diabetes Therapy, 9(3), 1307–1316. https://doi.org/10.1007/s13300-018-0441-1
World Bank Reports. (2023). Poverty and Equity: Africa, Western & Central (Nigeria, p. 3). World Bank.
Yu, T. S., Song, S., Yea, J., & Jang, K. (2024). Diabetes Management in Transition: Market Insights and Technological Advancements in CGM and Insulin Delivery. Advanced Sensor Research, 3(10), 2400048. https://doi.org/10.1002/adsr.202400048