Methods and systems are disclosed for determining a basal rate adjustment of insulin 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 determining a current risk metric associated with the detected glucose state based on a weighted average of cumulative hazard values of return paths generated from a glucose state distribution around a detected glucose state. The method may include 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 a reference risk metric associated with a reference glucose level.