An example system for therapy delivery includes one or more processors configured to in response to a prediction indicating that the meal event is to occur, output instructions to an insulin delivery device to deliver a partial therapy dosage, to a device to notify the patient to use the insulin delivery device to take the partial therapy dosage, or to the insulin delivery device to prepare the partial therapy dosage prior to the meal event occurring, and in response to a determination indicating that the meal event is occurring (e.g., based on movement characteristics of a patient arm), output instructions to the insulin delivery device to deliver a remaining therapy dosage, to the device to notify the patient to use the insulin delivery device to take the remaining therapy dosage, or to the insulin delivery device to prepare the remaining therapy dosage.