An integrated diabetes management system comprising a computer readable medium stored in memory that is configured to cause a processor to receive a data stream from a substantially continuous glucose sensor, the data stream, including one or more sensor data points, to calculate a therapy comprising instructions for administration of a medicament, and to automatically send the instructions to a medicament delivery device in a fully-automated mode unless a semi-automated mode is triggered, wherein the fully automated mode does not require user interaction to send instructions to the medicament delivery device, wherein the semi-automated mode requires user interaction before sending instructions to the medicament delivery device, and wherein the semi-automated mode is triggered responsive to detection of a clinical risk.