GlucOS: Security, correctness, and simplicity for automated insulin delivery

Abstract: We present GlucOS, a novel system for trustworthy automated insulin delivery. Fundamentally, this paper is about a system we designed, implemented, and deployed on real humans and the lessons learned from our experiences. GlucOS combines algorithmic security, driver security, and end-to-end verification to protect against malicious ML models, vulnerable pump drivers, and drastic changes in human physiology. We use formal methods to prove correctness of critical components and incorporate humans as part of our defensive strategy. Our evaluation includes both a real-world deployment with seven individuals and results from simulation to show that our techniques generalize. Our results show that GlucOS maintains safety and improves glucose control even under attack conditions. This work demonstrates the potential for secure, personalized, automated healthcare systems. Our source code is open source.