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Securing Automated Insulin Delivery Systems: A Review of Security Threats and Protectives Strategies (2503.14006v1)

Published 18 Mar 2025 in cs.CR

Abstract: Automated insulin delivery (AID) systems have emerged as a significant technological advancement in diabetes care. These systems integrate a continuous glucose monitor, an insulin pump, and control algorithms to automate insulin delivery, reducing the burden of self-management and offering enhanced glucose control. However, the increasing reliance on wireless connectivity and software control has exposed AID systems to critical security risks that could result in life-threatening treatment errors. This review first presents a comprehensive examination of the security landscape, covering technical vulnerabilities, legal frameworks, and commercial product considerations, and an analysis of existing research on attack vectors, defence mechanisms, as well as evaluation methods and resources for AID systems. Despite recent advancements, several open challenges remain in achieving secure AID systems, particularly in standardising security evaluation frameworks and developing comprehensive, lightweight, and adaptive defence strategies. As one of the most widely adopted and extensively studied physiologic closed-loop control systems, this review serves as a valuable reference for understanding security challenges and solutions applicable to analogous medical systems.

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