@Clare_T_Fishman, glad to hear from a happy fellow looper. You are much better connected than me. I have never seen a beer emoji on my Loop app. Where is it?
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My management techniques are not very polished. I don’t change the insulin to carb ratio, insulin sensitivity factor or basal rates very often but I will do it several times per year.
What I do utilize is the ability to set a temporary low or high target to mitigate an adverse real time trend. I think of it like driving a car and using the accellerator or the brake. I also inhale some Afrezza to knock down a trending high.
How is that very low ISF working for you? As long as the algorithm is making good decisions for you, that’s what really matters.
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How exciting! Congrats! Despite this being the first official no-hitter, you seem to have maintained terrific control and would have a boatload of them by other standards. Bravo!
I saw a graphic the other day illustrating how differently A1Cs can be defined. I haven’t noticed a change in Caleb’s A1C with looping - he’s consistently 6.0 or lower, pre and post Loop. There are benefits from Looping that are not captured in this measurement. I know we spend less brain power on diabetes. We sleep through the night. I’m certain his highs are not as high and lows not as low.
It still expect his A1C will be lower when it is tested though. Knowing how pre-Loop highs could at times be difficult to correct and with Loop they are not reached or much more easily corrected, it seems like he should still see a measurable improvement.
I’m letting my thoughts stray! Well done and thanks for sharing.
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The pivotal event was a night when my BG stayed at 110 for 8 hours. My target BG is set at 80. With Nightscout I verified that loop scheduled the correct amount of insulin, assuming ISF was correct. Obviously ISF was not correct. My insulin sensitivity varies quite a bit. Let’s assume that the correct ISF value is always between 10 and 30. The 2 interesting cases are:
- Loop ISF 30, optimal ISF 10.
- Loop ISF 10, optimal ISF 30.
Case 1 causes high BG as experienced during the pivotal night.
Case 2 would cause low BG if the delivery limit was set too high. I changed the delivery limit to 2x basal rate. The effect is that loop is very eager to correct my BG when it deviates from the target. The low delivery limit prevents loop from overdosing. Before my BG drops too low, loop can see the effect of IOB and dial back the temp basal.
My BG now consistently stays between 70-100 during the night. Almost every day I wake up with BG between 80-90. Absolutely perfect.
For me this is a ‘set it and forget it’ configuration. Changes in my insulin sensitivity seem to have very little impact on the outcome.
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@Lorraine, I am looping today because of your encouragement and posts about Caleb’s success with OmniPod DIY Loop. Thanks a lot.
My A1C also hasn’t changed and I don’t expect it to. My SD has improved from 25 to 20 which is what I was hoping for. Do you monitor Caleb’s SD?
I agree with you that loop’s upside is much more than what can be measured by A1C. Sleeping through the night without alarm is a big one. Another one is that now when I don’t pay attention to my BG, time works for me instead of against me. As icing on the cake, I no longer have to schlep the PDM brick around. Being able to use my iPhone to bolus is such a delight. I wonder how Insulet will get this toothpaste back in the tube. Dash is a joke, a sad one.
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Oh, how nice to hear. Happy to know Caleb’s experience has had a positive impact.
Well, yes, I see it and am aware of it. If monitoring extends to trying to figure out what to do to improve it, nope. It hasn’t changed and it’s not fabulous. At least I don’t think it is, I haven’t done any kind of deep dive to better appreciate its value.
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Your comment about playing with the ISF number in Loop prompted me to to experiment a bit. My ISF ranged from 30 to 50 over my 24 hour day with the low numbers (relative insensitivity) during the night and the high numbers (relative sensitivity) in the afternoon.
This morning, I aggressively chopped off 10 from each of my ISF rates and observed more Loop aggressiveness. I think I’ve already avoided at least one “whack-a-mole” Afrezza correction when compared to my recent daily patterns.
This reminds me that I could do better by more experimenting with Loop settings. My tendency is to be content with my settings once it’s producing desirable results. It’s part of my philosophy to accept a “healthy good enough” and focus my attention to other issues in my life.
As you’re well aware, I’m sure, even if you’ve discovered an array of settings that work generally well, diabetes can easily drift and that work-around you’re using every day around 3 pm, for example, is just not working as well as it used to.
Thanks for motivating me to try something different. Even after three years of using Loop, I’m still learning new things. I look forward to automated systems in the future that will learn how my body metabolizes glucose and then updates itself when my body decides to change. I won’t be happy, however, with any system that shoots for unambitious and unchangeable targets.
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Can anyone tell me how to configure the closed loop system with an Omnipod, Dexcom G6 and iPhone 6SE? Whenever I ask my endocrinologist about it, she says it’s “not out yet”, so I’m confused as to how you are doing it. Thanks!
I also suggest that you join the Looped group on Facebook. But as @Helmut said, you need to start with LoopDocs. And then you need to read LoopTips as you start using Loop. The instructions on LoopDocs are very methodical but you need to be very aware that this is Do It Yourself. Good luck!
Thank you both very much. I will give this a shot with the help of my very smart engineer husband. I’ll let you know how it goes!
Wish me luck!!
Before I started looping 4 months or so ago, I had never used anything Apple at all.
The documentation above is very detailed enough that anyone can do it. The key is to read it through completely a few times, then follow everything STEP BY STEP and don’t skip anything nor rush the process!
It truly does take DAYS the first time setting things up.
And if it is in your budget, order a 2nd rileylink as soon as you can for a backup. They currently are caught up and ship fairly quickly, but when I started they were on back order and it took over a month to get mine. It would suck to have one break, not have a backup, and then it be on back order. You’d have to go back to what you were using.
There are a few of us here looping so if you have any questions, start a new thread and be as detailed as you can and we will TRY to help. The best place really though is the FB group.
Lastly, make sure you do all of this YOURSELF on your own either virtual machine or Apple computer. Don’t borrow one or have friends d this for you. That is the only way to learn how to troubleshoot and how to do updates as they become available.
I wish you lots of luck!
I’m not looping, yet … but, looking forward to the day when I am able!
Not a first, but I haven’t seen this in many years: A1C 4.9.
In the early days of getting my Dexcom I had several A1Cs below 5. 4.9 was always my goal. When my BG control (SD) improved, my A1C got worse. No surprise there: I was not banking as many lows. I know that I should celebrate SD, not A1C. Old habits die hard.
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Congrats Helmut!!!
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I started Looping with the Omnipod Testing Branch when it was first introduced in April 2019. Yesterday I loaded the Dev 2.0 version and have been amazed at how much easier it is stay in range with Loop constantly adjusting in the background. My endo at the Joslin was impressed with the Tidepool reports. Although she can’t condone using a device that is not FDA approved, she still writes my rx for pods, Dex, and insulin. My QOL has improved exponentially along with my sleep. It’s wonderful to just have my iphone instead of pdm, dex receiver and phone. I’m looking forward to Tidepool approval so I can do this all with bluetooth instead of RileyLink. I just spent the holidays in a tiny village in northeast Belize, Central America. No problems with RL or Loop and it was as awesome vacation.
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I too installed the 2.0 version and love it. But one thing I still notice on my RL which is connected to an iPhone SE is that I have to turn it off and back on DAILY. It just looses connectivity and when I run the connectivity check it says no response. When I power cycle the RL it then works fine the rest of the day. I’m on the latest apple update, which is 13.3 and auto updates are turned on.
Anyone having similar issues? This happens DAILY and is a bit annoying.