Do-It-Yourself Artificial Pancreas Systems – what they are, how they work and how you can build one yourself today

Do-It-Yourself Artificial Pancreas Systems – what they are, how they work and how you can build one yourself today

So, every so often I see that somebody mentions the phrase „Loop“ on this subreddit. Nevertheless, this occurs within the remark part of different threads more often than not and it’s arduous to clarify these techniques in a couple of feedback. I’ve observed that the majority diabetics right here on Reddit don’t learn about so-called “DIY Closed Loop Methods” and that’s why I created this thread: To unfold consciousness about these techniques and how one can make the most of them.

Do I must be tech-savvy if I wish to proceed studying?

No! I attempted to clarify every part as simple as potential and even should you resolve to construct such a system your self you don’t want any information of programming and co.!

What are Closed Loop Methods?

Perhaps you’ve already heard about Closed Loop Methods within the media – diabetics and docs have been dreaming about them for many years, let me clarify why: Think about your diabetes management as an Open Loop with Three elements.

Half 1: Insulin Supply – That is carried out by your insulin pump or by a number of each day injectionsPart 2: Glucose Monitoring – That is carried out by a blood glucose meter or a CGMPart 3: Remedy Administration – That is carried out by your endo and particularly you (calculating insulin wants, monitoring the glucose, giving insulin, …)

Because the identify of Closed Loop Methods suggests they’re all about closing this loop you simply imagined. Your CGM ought to all the time talk your blood glucose worth to your pump, your insulin pump then analyzes the information, thinks of the very best remedy choice and mechanically offers you the required quantity of insulin or suspends your basal insulin. It’s all about eliminating the “You” within the Remedy Administration a part of your diabetes management, in order that it’s a must to make investments much less time in controlling your diabetes and have extra time to only have enjoyable and luxuriate in life.

What are Do-It-Your self Closed Loop Methods?

As you in all probability know, above-mentioned techniques don’t exist but commercially. Big firms like Medtronic and others have been failing terribly at innovating and bringing such merchandise to the mass market. That’s why some tech-savvy individuals had been like: “Okay, so we have now CGMs, we have now insulin pumps and everybody of us carries a smartphone that would run an algorithm. Why isn’t there a system but that makes these numerous merchandise speak to one another and automate my diabetes administration?”As a result of firms didn’t invent, they determined to take action and began programming their very own Closed-Loop-System that may mechanically handle their diabetes. Now there’s a complete neighborhood below the hashtag #WeAreNotWaiting that doesn’t wish to watch for firms to innovate however has determined to construct such techniques themselves.

How do Do-It-Your self Closed Loop Methods work?

One other glorious query (whoever is asking all of them should be a genius!). Do-It-Your self Closed Loop Methods normally run in your telephone and talk to your CGM and insulin pump always. They know your blood glucose, how a lot carbs you’ve eaten, how a lot IOB you could have and far, way more. They then use this information to calculate a mathematical mannequin of how your blood glucose degree will develop within the upcoming hours. Primarily based on this mannequin the system will then resolve to droop insulin supply (e.g. should you’re trending low) or give extra insulin (e.g. should you’re trending excessive).

The one downside is that a lot of the commercially out there insulin pumps don’t will let you remotely management your pump. (The algorithm must remotely management your pump to automate insulin supply – On most pumps it’s a must to enter every part your self) For this reason just some insulin pumps are suitable with Do-It-Your self Closed Loop Methods. They should have safety breaches that can be utilized to remotely management them. Due to this fact, just some insulin pumps can be utilized with these techniques. Extra on that later.

Why would I wish to use such a system?

As a result of it’s superior! All of us hate that we have now to handle our diabetes 24/7 (particularly at evening time), so it could be nice if a pc algorithm would help you, wouldn’t it? I’ve been utilizing such a system myself and I can inform you: It’s completely wonderful, particularly nighttime. I get up in goal vary mainly day-after-day because the system retains my blood sugar ranges good and regular in a single day (I don’t should get up anymore, I can sleep by each evening!) and are a pleasant help throughout day time. Additionally, you will have extra secure, nicer blood sugar ranges –> higher HbA1c / extra time in vary –> much less threat for diabetic problems and different bullshit.

That sounds nice! So I don’t should care about my diabetes anymore in any respect, proper?

No! Whereas these techniques may be capable to fulfill this dream sooner or later, we aren’t there but. These techniques aren’t there to switch you managing your diabetes however to help you. You’ll nonetheless should depend carbs and enter them into the system, you’ll nonetheless expertise highs and lows generally and you’ll nonetheless have to check your Carb-Ratio, Basal-Charges and co.

Are these techniques save?

This relies on what you outline as “save”. Resides with diabetes save? Is it protected to get up each evening due to a low or a excessive blood glucose worth? Is it protected to expertise a number of lows a day?

However the reply you’re in all probability on the lookout for is “Sure, these techniques are protected” and certainly they’re. The code has plenty of security options in order that the system received’t provide you with insulin while you’re trending low or your blood glucose is low already. You’ll nonetheless expertise some highs and lows with the system however they are going to be a lot much less extreme than should you haven’t been utilizing these techniques.

BUT remember the fact that these techniques aren’t accredited by the FDA or the EMA. There haven’t been any research to verify the protection of those techniques and also you received’t be capable to make anybody liable should you run into some form of malfunction. Please learn extra in regards to the security of those techniques on the DISCLAIMER on the backside of this put up.

What occurs if the system fails?

Properly, usually: Nothing. These techniques work by adjusting your basal fee through the use of Momentary basals – these are all the time set to a period of 30 minutes however will probably be up to date each 5 minutes if the techniques is working correctly. Now, let’s suppose the system crashes: The present non permanent basal fee will run out inside 30 minutes and your insulin pump will then proceed to offer you your regular basal fee – simply as should you wouldn’t be utilizing the system. It’ll keep this fashion till you could have time to resolve the issue with the system or the system manages to restart itself.

Okay, I’m satisfied. The place can I purchase one in all these techniques?

You possibly can’t. Like I’ve already talked about these techniques aren’t accredited by the FDA or EMA and thus will not be allowed to be bought. You’ll should construct one in all them your self, that’s why they’re referred to as Do-It-Your self Closed Loop Methods.

Okay, then: How can I construct one in all these techniques?

To begin with, it’s a must to resolve which system you wish to construct since there are numerous tasks on the market. I’ll now provide you with a small overview of the three most necessary tasks with the intention to simply resolve which one is likely to be the precise one for you:

  • Loop
    • works with the next insulin pumps:
      • very outdated Medtronic Insulin pumps (extra data on its web site)
      • OmniPod (not sprint, the older ones)
    • solely works on iPhones
      • helps Apple Watch (You need to use your watch to bolus and enter carbs – isn’t that cool!?)
  • OpenAPS
    • works with the next insulin pumps:
      • very outdated Medtronic Insulin pumps (extra data on its web site)
      • OmniPod (not sprint, the older ones) – not but, however “quickly”
    • solely works on a so-called “rig”, e.g. a Raspberry Pi or an Intel Edison Explorer Board
      • If you happen to're tech-savvy additionally, you will be capable to management the system utilizing your telephone / smartwatch
  • AndroidAPS
    • Works with the next insulin pumps:
      • Accu-Test Combo
      • Accu-Test Perception
      • DanaR
      • DanaRS
      • OmniPod (not sprint, the older ones) – not but, however "quickly"
    • solely works on Android Telephones

These techniques have way more variations however I believe that these are an important ones. If in case you have an iPhone, you’ll in all probability wish to use Loop. If in case you have an Android Telephone, you’ll in all probability wish to use AndroidAPS. I’d suggest OpenAPS solely to extra tech-savvy customers.Additionally, your alternative can in fact rely on the insulin pumps suitable with every system. A few of them aren’t commercially out there anymore and may solely be purchased used (this may be very costly) whereas others just like the OmniPod are nonetheless commercially out there and may simply be used with these techniques.Please be aware that these techniques don’t compete with one another. You’re going to get good outcomes with any of them and you’ll be amazed by any of them. Please take into consideration the techniques for a second after which proceed studying.

It’s time to construct the system!

So you could have determined which system you wish to construct – Nice. Nevertheless, I can’t information you thru the entire strategy of constructing the system since this has been documented by others already very properly. Due to this fact, I’ll simply hyperlink you to the related pages which have a lot extra data than my comparatively “brief” (contemplating how big this matter is) thread.Please learn by the entire documentation of your system earlier than you begin utilizing it. I imply it for actual. No person appears to hearken to that. Earlier than asking any query or beginning to use your system… READ EVERYTHING.

So, should you’ve determined to go together with Loop, then please go to these web sites:

https://loopkit.github.io/loopdocs/ (for constructing the system and normal data)

https://kdisimone.github.io/looptips/ (learn this if in case you have constructed the system and need some extra data on the way to correctly function it)

If you happen to’ve determined to go together with OpenAPS, please comply with this hyperlink:

https://openaps.readthedocs.io/en/newest/index.html

Final however not least: If you happen to’re going for AndroidAPS, that is the best way to go:

https://androidaps.readthedocs.io/en/newest/EN/

Wait, don’t go away but!

These web sites will information you thru the method of constructing your personal Do-It-Your self Closed Loop Methods. Nevertheless, you might need some technical questions or get caught at a sure step and need assistance. If you happen to’ve determined to construct such a system (even should you haven’t constructed it but) please be a part of this Fb-Group:

https://www.fb.com/teams/TheLoopedGroup/

There you possibly can ask any technical query and other people will probably be there that will help you out should you run into any issues. HOWEVER, PLEASE learn by the entire documentation of your system earlier than asking any questions on this group. A lot of your questions will probably be resolved by studying the documentation, I promise. If you happen to can’t discover the reply to your query within the docs, then be happy to ask within the Fb-Group.

Who do I’ve to thank for this?

That’s one other glorious query. Properly, actually not me. I didn’t write a single line of code on these numerous tasks. I simply wish to unfold consciousness on these thrilling tasks since I believe most individuals right here on Reddit don’t know that they exist, I’m actually penning this put up on the shoulders of giants.

But, there are tons of individuals you can say thanks to. The programmers, the neighborhood managers within the Fb-Group and everybody who’s investing time in serving to others with constructing these techniques and working them. If you wish to say “Thanks” to the folks that deserve to listen to it, be happy to take action within the Fb-Group. The programmers and everybody else will probably be there to listen to it!

DISCLAIMER

So, I don’t wish to sound adverse now on this part of the put up nevertheless it’s one thing I’ve to do with the intention to shield me and others from entering into hassle… So please concentrate on the next details:

You’re constructing this technique by yourself behalf. You’ll have to take full duty if something ought to occur to you. Neither I nor the programmers of those techniques may be made liable in case your system fails or has any malfunctions. You constructed this technique your self and thus you’re taking full duty. You freely determined to make use of an experimental piece of software program and due to this fact should take full legal responsibility. Thanks!

Do you could have anything to say?

Ha, you wager! I would edit this thread a couple of instances sooner or later to appropriate any potential errors or make clear some issues which may not be simple to anybody, so be happy to all the time come again to this thread. To the opposite customers of DIY-APS techniques on the market: If you happen to really feel one thing on this thread is incorrect or deceptive otherwise you assume one thing needs to be added, be happy to contact me and I’ll make sure you make the required adjustments to this thread. Additionally be happy to hyperlink to this thread should you see that somebody mentions “Loop” or one thing like this within the feedback of one other thread and other people ask what they’re referring to. Additionally, if in case you have some normal questions be happy to write down a remark to this thread. I’m presently having my last exams and I actually needs to be finding out for them as an alternative of penning this put up however naah. Nevertheless, I’ll attempt to reply any questions as quick as potential. If there are too many I’ll attempt to get another Loop-Customers on this thread too… or perhaps nobody cares about this thread and there received’t be any questions – we’ll see. BUT please maintain questions concerning on the way to construct these techniques, the way to function them and troubleshooting to the Looped-Fb-Group.

So… that’s it. Thanks for studying this fairly lengthy textual content. Perhaps, by now, you’ve began to love (or hate) me however I concern it’s time to say goodbye now. I want you the very best of luck constructing one in all these techniques if in case you have determined to take action and good luck along with your diabetes. It’s a horrible illness that may actually get on one’s nerves nevertheless it’s good to know that there are individuals and expertise on the market making it suck loads much less. I’ve been utilizing a Closed Loop System for half a 12 months now already and this was in all probability the very best time of my life. I get up in vary day-after-day, I’ve a lot extra time to focus on non-diabetes issues and I can dwell a a lot more healthy life. It’s really indescribable.

So… maintain your blood sugars good and regular and have an amazing day!

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