Rayhan Lal

Rayhan Lal, MD, Assistant Professor, Department of Pediatrics, Division of Endocrinology and Diabetes; Assistant Professor, Department of Medicine, Division of Endocrinology, Gerontology, & Metabolism, Stanford University School of Medicine

Research Description: As an electrical engineer and computer scientist with type 1 diabetes, Dr. Lal’s primary research interest is the design, development and testing of new diabetes technology and therapeutics. The significance of informed type 1 diabetes clinical practice became clear to him after his two younger sisters also developed diabetes. He decided to devote himself to medicine and is now an adult and pediatric endocrinologist at Stanford. He works extensively with Dr. Bruce Buckingham testing new commercial subcutaneous autonomous (closed-loop) insulin delivery systems. Iterative improvements continue to advance these systems, which remain limited by the complex kinetics of insulin activity. This manifests as systems requiring meal announcements, favoring hypoglycemia or hyperglycemia, and then activating alarms when the user inevitably hits the opposite extreme. Dr. Lal collaborates with many members of SDRC, QSU and open-source diabetes community to bypass the technological and human factor limitations of existing devices. He is also co-leader of the SDRC Bioengineering & Behavioral Sciences Research Affinity Group.

Selected relevant publications: 

  1. Hsu L, Buckingham B, Basina M, Ekhlaspour L, von Eyben R, Wang J, Lal RA. Fast-Acting Insulin Aspart Use with the MiniMedTM 670G System. Diabetes Technol Ther. 2021 Jan;23(1):1-7. doi: 10.1089/dia.2020.0083. PMID: 32520594. 

  2. Lum J, Bailey R, Barnes-Lomen V, Naranjo D, Hood K, Lal RA, Arbiter B, Brown A, DeSalvo DJ, Pettus J, Calhoun P, Beck RW. A Real-World Prospective Study of the Safety and Effectiveness of the Loop Open Source Automated Insulin Delivery System. Diabetes Technol Ther. 2020 Nov 23. doi: 10.1089/dia.2020.0535. PMID: 33226840. 

  3. Lal R, Maahs D. Clinical Use of Continuous Glucose Monitoring in Pediatrics. Diabetes Technol Ther. 2017 May;19(S2):S37-S43. doi: 10.1089/dia.2017.0013. PMID: 28541138; PMCID: PMC5444498.  

  4. Lal R, Basina M, Maahs DM, Hood K, Buckingham B, Wilson DM. One Year Clinical Experience of the First Commercial Hybrid Closed-Loop System. Diabetes Care. 2019 Dec;42(12):2190-2196. doi: 10.2337/dc19-0855. PMID: 31548247; PMCID: PMC6868462. [Cites P30] 

  5. Lal R, Cuttriss N, Haller MJ, Yabut K, Anez-Zabala C, Hood KK, Sheehan E, Basina M, Bernier A, Baer LG, Filipp SL, Wang CJ, Town MA, Gurka MJ, Maahs DM, Walker AF. Primary Care Providers in California and Florida Report Low Confidence in Providing Type 1 Diabetes Care. Clin Diabetes. 2020 Apr;38(2):159-165. doi: 10.2337/cd19-0060. PMID: 32327888; PMCID: PMC7164993. [Cites P30] 

  6. Figg L, Addala A, Jain I, Anez C, Midney P, DeChirico C, Symanski C, Fitzgerald BC, Colbert K, Raymer T, Stockton-Joreteg C, Murphy E, Collins L, Bernstein C, Hechavarria M, Sheehan EP, Bernier A, Westen SC, Hood KK, Zaharieva DP, Basina M, Cuttriss N, Filipp SL, Gurka MJ, Walker AF, Maahs DM, Haller MJ, Lal RA. The Promising Success of Project Extension for Community Healthcare Outcomes (ECHO) Diabetes: Case Series. JMIR Diabetes. 2023 Aug 3;8:e46050. doi: 10.2196/46050. PMID: 37535407; PMCID: PMC10436109. 

  7. Lal RA, Leelarathna L. Insulin Delivery Hardware: Pumps and Pens. Diabetes Technol Ther. 2023 Feb;25(S1):S30-S43. doi: 10.1089/dia.2023.2503. PMID: 36802186; PMCID: PMC10081698. 

  8. Forlenza GP, Lal RA. Current Status and Emerging Options for Automated Insulin Delivery Systems. Diabetes Technol Ther. 2022 May;24(5):362-371. doi: 10.1089/dia.2021.0514. Epub 2022 Mar 14. PMID: 35099302; PMCID: PMC9131039. 

  9. Braune K, Lal RA, Petruželková L, Scheiner G, Winterdijk P, Schmidt S, Raimond L, Hood KK, Riddell MC, Skinner TC, Raile K, Hussain S; OPEN International Healthcare Professional Network and OPEN Legal Advisory Group. Open-source automated insulin delivery: international consensus statement and practical guidance for health-care professionals. Lancet Diabetes Endocrinol. 2022 Jan;10(1):58-74. doi: 10.1016/S2213-8587(21)00267-9. Epub 2021 Nov 13. Erratum in: Lancet Diabetes Endocrinol. 2022 Jan;10(1):e1. doi: 10.1016/S2213-8587(21)00324-7. PMID: 34785000; PMCID: PMC8720075. 

  10. Wong JJ, Suttiratana SC, Lal RA, Lum JW, Lanning MS, Dunlap A, Arbiter B, Hanes SJ, Bailey RJ, Hood KK, Naranjo D. Discontinued Use of the Loop Insulin Dosing System: A Mixed-Methods Investigation. Diabetes Technol Ther. 2022 Apr;24(4):241-248. doi: 10.1089/dia.2021.0362. PMID: 34780283; PMCID: PMC9057870. 

  11. Suttiratana SC, Wong JJ, Lanning MS, Dunlap A, Hanes SJ, Hood KK, Lal RA, Naranjo D. Qualitative Study of User Experiences with Loop, an Open-Source Automated Insulin Delivery System. Diabetes Technol Ther. 2022 Jun;24(6):416-423. doi: 10.1089/dia.2021.0485. Epub 2022 May 12. PMID: 35099278; PMCID: PMC9208860. 

  12. Lal RA, Robinson H, Lanzinger S, Miller KM, Pons Perez S, Kovacic R, Calhoun P, Campbell F, Naeke A, Maahs DM, Holl RW, Warner J. Temporal Changes in Hemoglobin A1c and Diabetes Technology Use in DPV, NPDA, and T1DX Pediatric Cohorts from 2010 to 2018. Diabetes Technol Ther. 2022 Sep;24(9):628-634. doi: 10.1089/dia.2022.0095. PMID: 35856740; PMCID: PMC9634993. 

  13. Forlenza GP, Vigers T, Berget C, Messer LH, Lal RA, Basina M, Maahs DM, Hood K, Buckingham B, Wilson DM, Wadwa RP, Driscoll KA, Pyle L. Predicting Success with a First-Generation Hybrid Closed-Loop Artificial Pancreas System Among Children, Adolescents, and Young Adults with Type 1 Diabetes: A Model Development and Validation Study. Diabetes Technol Ther. 2022 Mar;24(3):157-166. doi: 10.1089/dia.2021.0326. Epub 2021 Dec 1. PMID: 34780306; PMCID: PMC8971998. 

  14. Maikawa CL, d'Aquino AI, Lal RA, Buckingham BA, Appel EA. Engineering biopharmaceutical formulations to improve diabetes management. Sci Transl Med. 2021 Jan 27;13(578):eabd6726. doi: 10.1126/scitranslmed.abd6726. PMID: 33504649; PMCID: PMC8004356. 

  15. Lal RA, Leelarathna L. Insulin Delivery Hardware: Pumps and Pens. Diabetes Technol Ther. 2021 Jun;23(S2):S32-S45. doi: 10.1089/dia.2021.2503. PMID: 34061635; PMCID: PMC8881955. 

  16. Lal RA, Hsu L, Zhang J, Schøndorff PK, Heschel M, Buckingham B. Longevity of the novel ConvaTec infusion set with Lantern technology. Diabetes Obes Metab. 2021 Aug;23(8):1973-1977. doi: 10.1111/dom.14395. Epub 2021 Apr 18. PMID: 33822472; PMCID: PMC8720264. 

  17. Maikawa CL, Chen PC, Vuong ET, Nguyen LT, Mann JL, d'Aquino AI, Lal RA, Maahs DM, Buckingham BA, Appel EA. Ultra-Fast Insulin-Pramlintide Co-Formulation for Improved Glucose Management in Diabetic Rats. Adv Sci (Weinh). 2021 Sep 9:e2101575. PMID: 34499434. 

  18. Lal RA, Maikawa CL, Lewis D, Baker SW, Smith AAA, Roth GA, Gale EC, Stapleton LM, Mann JL, Yu AC, Correa S, Grosskopf AK, Liong CS, Meis CM, Chan D, Garner JP, Maahs DM, Buckingham BA, Appel EA. Full closed loop open-source algorithm performance comparison in pigs with diabetes. Clin Transl Med. 2021 Apr;11(4):e387. PMID: 33931977; PMCID: PMC8087942. 

  19. Hussain S, Lal RA, Braune K. Open-source automated insulin delivery in type 1 diabetes-the evidence is out there. Lancet Diabetes Endocrinol. 2022 Dec;10(12):835-836. doi: 10.1016/S2213-8587(22)00283-2. Epub 2022 Oct 14. PMID: 36244346; PMCID: PMC9943818. 

  20. Corbett JP, Hsu L, Brown SA, Kollar L, Vleugels K, Buckingham B, Breton MD, Lal RA. Smartwatch gesture-based meal reminders improve glycaemic control. Diabetes Obes Metab. 2022 Aug;24(8):1667-1670. PMID: 35491517; PMCID: PMC9262849. 

  21. Lal RA, Moeller HP, Thomson EA, Horton TM, Lee S, Freeman R, Prahalad P, Poon ASY, Annes JP. Novel Pathogenic De Novo INS p.T97P Variant Presenting With Severe Neonatal DKA. Endocrinology. 2022 Feb 1;163(2):bqab246. doi: 10.1210/endocr/bqab246. PMID: 34888628. 

  22. Zaharieva DP, Morrison D, Paldus B, Lal RA, Buckingham BA, O'Neal DN. Practical Aspects and Exercise Safety Benefits of Automated Insulin Delivery Systems in Type 1 Diabetes. Diabetes Spectr. 2023 May;36(2):127-136. doi: 10.2337/dsi22-0018. Epub 2023 May 15. PMID: 37193203; PMCID: PMC10182962. 

  23. Wong JJ, Hood KK, Hanes SJ, Lal RA, Naranjo D. Psychosocial Effects of the Loop Open-Source Automated Insulin Delivery System. J Diabetes Sci Technol. 2023 Nov;17(6):1440-1447. doi: 10.1177/19322968221105288. Epub 2022 Jun 30. PMID: 35771004; PMCID: PMC10658689. 

  24. Hughes MS, Douvas JL, Layfield-Bryan M, Blanco LE, Gray JC, Zapotoczny G, Espinoza J, Wilcox JH, Lal RA. Frequency and Detection of Insulin Infusion Site Failure in the Type 1 Diabetes Exchange Online Community. Diabetes Technol Ther. 2023 Jun;25(6):426-430. doi: 10.1089/dia.2023.0005. Epub 2023 Mar 20. PMID: 36856574; PMCID: PMC10398731. 

  25. Wang CJ, Lewit EM, Clark CL, Lee FW, Maahs DM, Haller MJ, Addala A, Lal RA, Cuttriss N, Baer LG, Figg LE, Añez-Zabala C, Sheehan EP, Westen SC, Bernier AV, Donahoo WT, Walker AF. Multisite Quality Improvement Program Within the Project ECHO Diabetes Remote Network. Jt Comm J Qual Patient Saf. 2024 Jan;50(1):66-74. doi: 10.1016/j.jcjq.2023.08.001. Epub 2023 Aug 12. PMID: 37718146. 

  26. Blanco LE, Wilcox JH, Hughes MS, Lal RA. Development of a Real-time Force-based Algorithm for Infusion Failure Detection. J Diabetes Sci Technol. 2024 Nov;18(6):1313-1323. doi: 10.1177/19322968241247530. Epub 2024 Apr 23. PMID: 38654491; PMCID: PMC11535327. 

  27. Lee MY, Seav SM, Ongwela L, Lee JJ, Aubyrn R, Cao FY, Kalinsky A, Aparicio Ramos O, Gu Y, Kingston K, Ivanovic M, Buckingham BA, Desai D, Lal RA, Tan M, Basina M, Hughes MS. Empowering Hospitalized Patients With Diabetes: Implementation of a Hospital-wide CGM Policy With EHR-Integrated Validation for Dosing Insulin. Diabetes Care. 2024 Oct 1;47(10):1838-1845. doi: 10.2337/dc24-0626. PMID: 39140891; PMCID: PMC11417271. 

  28. Hughes MS, Pasquel FJ, Davis GM, Lal RA, Buckingham BA, Boughton CK, Brown SA, Bally L. Toward Automation: The Road Traveled and Road Ahead for Integrating Automated Insulin Delivery into Inpatient Care. Diabetes Technol Ther. 2025 Mar;27(3):217-242. doi: 10.1089/dia.2024.0343. Epub 2024 Dec 2. PMID: 39618315; PMCID: PMC11971560. 

  29. Walker AF, Haller MJ, Addala A, Filipp SL, Lal RA, Gurka MJ, Figg LE, Hechavarria M, Zaharieva DP, Malden KG, Hood KK, Westen SC, Wong JJ, Donahoo WT, Basina M, Bernier AV, Maahs DM; ECHO Diabetes Study Team. Project ECHO Diabetes Trial Improves Outcomes for Medically Underserved People. Diabetes Care. 2025 Feb 1;48(2):243-250. doi: 10.2337/dc24-2100. PMID: 39688288; PMCID: PMC11770159. 

  30. Thomson EA, Lee S, Xu H, Moeller H, Sands J, Lal RA, Annes JP, Poon ASY. Intermittent Low-Magnitude Pressure Applied Across Macroencapsulation Devices Enables Physiological Insulin Delivery Dynamics. Diabetes. 2025 Jun 1;74(6):873-884. doi: 10.2337/db24-0818. PMID: 40029687; PMCID: PMC12097455. 

  31. Hughes MS, Pasquel FJ, Davis GM, Lal RA, Buckingham BA, Boughton CK, Brown SA, Bally L. Toward Automation: The Road Traveled and Road Ahead for Integrating Automated Insulin Delivery into Inpatient Care. Diabetes Technol Ther. 2025 Mar;27(3):217-242. doi: 10.1089/dia.2024.0343. Epub 2024 Dec 2. PMID: 39618315; PMCID: PMC11971560.