The present disclosure relates to a system and method for determining a basal rate adjustment based on risk associated with a glucose state of a person with diabetes. A method may include detecting a glucose state of the person based on a received glucose measurement signal and determining a current risk metric associated with the detected glucose state. The method may include identifying a reference glucose state and a reference risk metric associated with the reference glucose state, and calculating an adjustment to a basal rate of a therapy delivery device based on the current risk metric associated with the detected glucose state and the reference risk metric associated with the reference glucose level.