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Trio — Device Guide | Juicebox Podcast
Device Guide · DIY Automated Insulin Delivery

Trio

A free, open-source automated insulin delivery app for iPhone. Trio grew out of the FreeAPS X / OpenAPS lineage, runs the oref algorithm, and now supports Omnipod DASH, Omnipod Eros, and — in open beta — Omnipod 5 pods, plus Dexcom and Libre CGMs.

🔧 Open-Source · iPhone · oref Algorithm · Community-Built

DIY systems are not FDA-approved and involve building and maintaining the app yourself. Specifications change frequently — always verify current information with the project's own documentation. Full disclaimer.

Juicebox Podcast · Trio Project · triodocs.org
Apple Podcasts Spotify

New to Trio? Start here.

⚠️

Important: Trio is a free, open-source, do-it-yourself system. It is not FDA-approved, not sold by a company, and not prescribed. You build the app yourself and are responsible for maintaining it. This guide is educational; it is not instructions to build or use Trio, and not medical advice. Work with your care team and rely on the project's own documentation at triodocs.org.

What Is Trio?

Open-Source Automated Insulin Delivery

Trio is a free, community-built automated insulin delivery (AID) app for iPhone. It grew out of the FreeAPS X project (itself derived from the OpenAPS / oref lineage) and was renamed and expanded by a volunteer community. Trio runs the oref algorithm to automate insulin delivery using CGM data, and it works with a range of pumps — including Omnipod DASH and Omnipod Eros pods, and, in open beta, Omnipod 5 pods. Because it's open-source and self-built, Trio offers deep customization, but it also carries the responsibilities of a DIY system: you build it, maintain it, and take on the risk.

Free & open-source iPhone oref algorithm Omnipod DASH & Eros Omnipod 5 pods (open beta) Dexcom & Libre CGMs Community-supported
🔧

You Build It

Trio isn't downloaded from the App Store as a finished product. You compile the app yourself (typically with a Mac and Xcode, or a browser-based build method) and install it on your own iPhone. This is the defining feature — and responsibility — of a DIY system.

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oref Algorithm

Trio runs the oref algorithm from the OpenAPS lineage — the same algorithmic family that pioneered DIY closed-loop. It predicts glucose and adjusts insulin using your settings, with options like Dynamic ISF for advanced users.

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Pump Support

Trio supports Omnipod DASH and Omnipod Eros pods. As of the July 2026 open beta, it also supports Omnipod 5 pods (via the community's feat/o5 work) — expanding tubeless DIY options. Confirm current pump support in the project docs.

📡

CGM Support

Trio works with Dexcom (G6, G7) and FreeStyle Libre sensors, among others, for the CGM data that drives its automation. Available CGM integrations evolve with the project.

Trio is the community's insulin-delivery app: free, open-source, and built by the people who use it. That openness buys deep customization — and asks you to take on building and maintaining it yourself.

— Juicebox Podcast Trio Guide

🎧 Juicebox Podcast · Algorithm Pumping & DIY

SERIESAlgorithm Pumping — Loop, Trio, AndroidAPS & the DIY landscape EPISODESBrowse all Juicebox episodes on DIY and automated insulin delivery
For Clinicians · Quick Reference

Trio — Quick Clinical Summary

What It Is

Free, open-source DIY AID app for iPhone running the oref algorithm (OpenAPS/FreeAPS X lineage). Not FDA-approved, not manufacturer-supported. Patient builds and maintains it.

Pumps & CGMs

Omnipod DASH and Eros pods; Omnipod 5 pods in open beta (feat/o5). CGMs include Dexcom G6/G7 and FreeStyle Libre. Confirm current support in project docs.

Who Chooses It

Patients who want deep customization, tubeless DIY looping, and community support, and who are comfortable building/maintaining their own system. Often already engaged, tech-comfortable users.

Your Role

Support the patient's glycemic goals regardless of the tool. Many settings (basal, ICR, ISF, targets) mirror standard therapy. You don't prescribe or build Trio, but you can help interpret data and set targets.

📚
Trio Documentation — triodocs.org The project's own official documentation and build guides

Sources

triodocs.org — Trio Official Documentation github.com/nightscout/Trio — Trio Source Repository juiceboxpodcast.com — Algorithm Pumping Series
Getting the Most from It

Settings, the Algorithm & Daily Use

Trio gives you an unusual amount of control for an AID system — which is the point of DIY. Understanding the core settings and how the oref algorithm uses them is how you get good results while keeping the system safe.

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Core Settings

Trio uses standard therapy settings — basal rates, insulin-to-carb ratio (ICR), insulin sensitivity factor (ISF), and glucose targets — as the foundation the algorithm builds on. Good foundational settings are essential before enabling advanced features.

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Dynamic ISF & Dynamic CR

Advanced options let the algorithm scale sensitivity (and optionally carb ratio) based on glucose and IOB. Powerful for experienced users, but layered on top of solid basics — not a substitute for them.

🛡️

Safety Limits

Settings like Max IOB, Max Basal, and safety thresholds cap how much the system can do. These guardrails matter enormously in a self-built system — they are the boundaries that keep automation within safe limits.

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Duration of Insulin Action

DIA is a user-set profile value that tells the algorithm how long insulin keeps working. It is not locked to a fixed number — you set it (commonly around 6–7 hours for modern rapid insulins), with a project-defined minimum. Set it to match your insulin, not a default.

Trio runs the oref algorithm: every 5 minutes it takes your CGM data, insulin on board, carbs on board, and your settings, and predicts where glucose is heading. Based on that prediction and your target, it adjusts basal delivery (temporary basal rates) and can deliver automatic correction boluses (super-micro-boluses, or SMB, if enabled) to nudge glucose toward target. It works within the safety limits you've set (Max IOB, Max Basal, thresholds). The behavior is highly configurable, which is both Trio's strength and the reason good settings and understanding matter.
As of a July 2026 Nightscout Foundation announcement, Trio added open-beta support for using Omnipod 5 pods with the Trio app (via the community's feat/o5 branch work). This means the tubeless Omnipod 5 pod hardware can be driven by Trio's oref algorithm in a DIY context, in addition to the already-supported DASH and Eros pods. As open beta, it is early and evolving — anyone considering it should follow the project's own documentation and community channels for current status, stability, and instructions rather than relying on any third-party summary.
Because Trio is DIY, you build the app yourself — historically with a Mac and Xcode, though browser-based build methods have lowered the barrier. Apple-signed builds typically need renewal periodically (an Apple Developer account, ~$99/year, allows longer signing intervals; free accounts require more frequent rebuilds). You're responsible for updating the app when the community releases changes, and for keeping your build working. This ongoing maintenance is the tradeoff for the openness and customization DIY provides. The project documentation walks through the current build options.
Trio is supported by its volunteer community rather than a manufacturer. Help comes from the project documentation (triodocs.org), community forums, Facebook groups, and Discord channels where experienced users and contributors answer questions. There's no customer-service line or warranty. For many DIY users this community support is robust and responsive, but it's important to understand that it is peer support, not a regulated manufacturer's obligation. Your medical care team remains your clinical resource.
For Clinicians · Supporting Trio Users

Working with Patients Who Use Trio

Meet Them Where They Are

Many Trio users are highly engaged and knowledgeable. You don't need to build or endorse the system to support the patient — focus on glycemic goals, data review, and safety. The core settings map to standard therapy concepts.

Data Review

Trio users typically run Nightscout and/or share CGM data, giving rich data for review. Familiar metrics (time in range, patterns) apply. You can help interpret trends and adjust targets and settings collaboratively.

Safety Conversations

Reinforce safety limits (Max IOB, thresholds), site care, and having backup insulin delivery. Because it's self-maintained, discuss what the patient does if a build expires or a pump/CGM integration breaks.

Scope & Documentation

Note in the chart that the patient uses a DIY system. You're supporting their care, not prescribing Trio. Direct build/technical questions to the project's documentation and community, keeping your role clinical.

📚
Trio Documentation — triodocs.org Official build guides, settings reference, and community links

Sources

triodocs.org — Trio Official Documentation github.com/nightscout/Trio — Trio Source Repository juiceboxpodcast.com — Algorithm Pumping Series
Deep Dive

The Lineage, the Algorithm & the Full Picture

Trio sits within the open-source AID movement that predates every commercial system. Understanding where it comes from and how it works explains both its capabilities and the responsibilities it carries.

The open-source AID movement began with OpenAPS (2014), which established the oref algorithm and the closed-loop concepts every later system built on. FreeAPS X brought an oref-based looping app to iPhone. That project was renamed and expanded by the community into Trio, which continues to develop the app — adding pump support (DASH, Eros, and Omnipod 5 in open beta), refining the algorithm options, and improving the build experience. Trio is thus a direct descendant of the original DIY looping work, carried forward by a volunteer community.
oref (OpenAPS reference design) predicts glucose using CGM data, insulin on board, and carbs, then adjusts insulin via temporary basal rates and, when enabled, super-micro-boluses (SMB) — small automatic correction boluses that let the system respond more assertively to rising glucose than basal changes alone. Advanced features like Dynamic ISF scale sensitivity based on current glucose and IOB. All of this operates within user-set safety limits. The algorithm is powerful and configurable; its behavior depends heavily on settings, which is why understanding them matters in a DIY context.
In Trio, DIA (duration of insulin action) is a value you set in your profile to reflect how long your insulin keeps working — it is not fixed at a single mandatory number. For modern rapid-acting insulins, users commonly set DIA in the range of about 6–7 hours, and the project enforces a sensible minimum rather than a one-size default. Setting DIA to match your actual insulin (and confirming with your care team) helps the algorithm calculate insulin on board accurately, which affects correction timing and safety. Always follow the project documentation for current guidance.
The July 2026 open-beta support means Trio's oref algorithm can drive Omnipod 5 pod hardware in a DIY context (community feat/o5 work), alongside existing DASH and Eros support. Importantly, this is the community using the pod hardware with Trio's own algorithm — it is distinct from Insulet's commercial Omnipod 5 SmartAdjust system. As open beta, it is early, evolving, and not a finished or FDA-cleared product. Anyone interested should rely entirely on the project's own documentation and community channels for current status, stability, and instructions rather than any third-party description.
  • Not FDA-approved: Trio is not a regulated medical device; there's no manufacturer warranty or liability.
  • You build and maintain it: compiling the app, renewing signed builds, and updating when the community releases changes.
  • Peer support, not customer service: help comes from documentation and community, not a company help line.
  • Safety is on you: setting and respecting safety limits, keeping backup insulin delivery, and involving your care team.
  • The upside — openness, customization, and rapid community innovation — comes paired with these responsibilities.
For Clinicians · Full Reference

Trio — Complete Clinical Summary

Origin & Algorithm

OpenAPS → FreeAPS X → Trio. Runs oref (temp basal + optional SMB), with Dynamic ISF/CR options. Community-developed, iPhone-based. Not FDA-approved.

Pumps

Omnipod DASH and Eros pods. Omnipod 5 pods in open beta (feat/o5, July 2026). Confirm current support and stability in project docs.

CGMs

Dexcom G6/G7, FreeStyle Libre, among others. Integrations evolve with the project. CGM data drives 5-minute algorithm cycles.

Key Settings

Basal, ICR, ISF, targets; Max IOB/Max Basal/thresholds as safety limits; user-set DIA (commonly ~6–7h, project minimum enforced). Dynamic options for advanced users.

Support Model

Volunteer community + documentation (triodocs.org), forums, Discord. No manufacturer warranty or help line. Patient self-maintains builds.

Clinician Role

Support glycemic goals and data review; reinforce safety and backup plans; document DIY use. You don't prescribe or build Trio. Technical questions go to the project.

📚
Trio Documentation — triodocs.org (Official) Build guides, settings reference, algorithm docs, community links
💻
Trio Source Repository — github.com/nightscout/Trio Open-source code, releases, and the feat/o5 open-beta work

Sources

triodocs.org — Trio Official Documentation github.com/nightscout/Trio — Trio Source Repository openaps.org — OpenAPS: Origin of the oref Algorithm juiceboxpodcast.com — Algorithm Pumping Series
⚠️ This content is for educational purposes only and is not medical advice, and it is not instructions to build or operate a DIY system. Trio is a free, open-source, do-it-yourself project that is not FDA-approved and not manufacturer-supported; you build and maintain it yourself and assume the associated risks. Information here is drawn from the Trio project documentation (triodocs.org), the project source repository, and public community announcements, and it changes frequently — always verify current details with the project's own documentation and community. Always consult your healthcare provider before making changes to your diabetes management. Full disclaimer.

Juicebox Podcast · juiceboxpodcast.com · Research compiled from Trio project documentation, source repository, and community announcements.

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