Australia’s radio national Science Show will broadcast today on DIY looping and diabetes tech. Personal stories. Need for CGM coverage. Impact of tech on peoples’ lives. I was one of the people interviewed along with Jim Matheson and Tien‐Ming Hng. I think it will resonate with a lot of people!
Check it out now via podcast: DIY 'loopers' take diabetes into their own hands - ABC Radio National
Thanks for posting this, @MA11! Listening now. I added the DIY Closed Loop Systems category to your post.
Well done explanation for how the do-it-yourself Looping system is built. I’ve lived with Loop since 2016, so I’m happy with the safety and quality of life that it gives me.
People invested in current diabetes treatment schemes, such as clinicians and other medical professionals, are often skeptical at first, especially about the safety aspect.
At the very end of this 16 minute podcast, a sentiment is expressed that resonates with me. Diabetes is an inherently dangerous disease. Looping makes it safer.
Thanks Terry! I love your posts and absolutely relate to your comments just now.
Jim Matheson who was interviewed for the show has written a few posts on medium Jim is CrushingT1D – Medium and I wrote up my story as a blog in case anyone is interested. It’s here if anyone is keen to know more: https://myartificialpancreas.net/
Hi Terry! I’ve read your posts with interest since I found TuDiabetes and thank you for the all the information. I think I have a mental block about this DIY Looping. LOL I cannot wrap my head around WHAT is it! Maybe its brain damage, or memory loss … I dunno! But I can’t make sense of the whole thing! Are people keeping track of … what? Their weight, carb/insulin intake, exercise, illness/stress, and all this does … what better than Dexcom G6 and Omnipod?? I remain confused about the benefits because I simply don’t understand WHAT looping is. And please, don’t give me a video to watch cause they are generic, and none have caused the lightbulb in my brain to blink on! I am on what others call HIGH doses of insulin, two kinds – R in the pod and for bolus, and U200/60 mg each twice a day. It’s made me gain weight, but it’s also lowered my A1C to 7, for the first time in like 15 years. I’m so happy about that, I tend not to go looking for “better” – but everyone says Looping is better. WHAT makes it better?? How is is better? You seem to have the skinny on most everything diabetic!
I wish we could come up with a way to make the neuropathy stop. Or even go back to the the way things were before the 15 years of being ignored. My feet are … history. So is my balance. And my memory. Diabetes is going to kill me. I know this. Two heart attacks, two CVAs – 2000, 2001, 2005, 2007. Now, my muscles and nerves are simply shot. I get ‘charlie horses’ all over my body, my toes curl in and out painfully when relaxed, basically, I’m a mess, I admit it. I once was a promising scholar in medical anthropology, but now, I can’t remember where I put my cell phone five minutes ago. Sigh.
Looping is a program that you build on your phone that uses the readings from your CGM to give you more insulin when you are high and less insulin/stop insulin delivery when you are low or predicted to go low. You use your phone for everything and stop using the functions on your pump entirely. The communication is accomplished by using a device called Riley Link which delivers the information to the pump instead of you pressing the buttons on the pump.
Looping is a tool that can make diabetes care easier but it does have a steep learning curve including having to learn how to build an app by yourself with instructions from the DIY community.
Well, let’s see if I can clearly explain.
Since you’ve lived with diabetes and insulin dosing long-term, I’ll start by examining a typical manual insulin dosing scheme that most of us started on.
We take insulin for two main reasons. First, we use it to metabolize our meals and counteract unhealthy blood glucose rise. This is called bolus insulin.
Second, we need to metabolize the glucose called glycogen that is steadily pulsed from the liver. One can do this taking a long acting insulin like Tresiba or by using an insulin pump to provide a basal rate drip of insulin around the clock.
So what cognitive process do we step through to calculate insulin dose sizes? Usually, with meals, we consider the carbohydrate content of what we intend to eat and base our insulin dose on grams of carbohydrates.
For example, if our meal contains 50 grams of carbs and our insulin to carb ratio is 1:10, then we’d take 5 units of insulin (50/10=5).
The basal insulin is taken via a pen/syringe or a pump basal rate.
Sometimes we need to correct high blood sugar using an extra bolus of insulin. We calculate the size of this dose using something called an insulin sensitivity factor or ISF. This is a personal customized amount in mg/dL (or mmol/L) that one unit of insulin will drop your glucose level.
What does this have to do with Loop, an automated insulin dosing system? The short answer is that Loop takes over much of the cognitive load doing the tasks I listed above.
Every five minutes, Loop examines the current blood sugar as measured by the CGM and decides whether to add or withhold insulin. Loop then sets a temporary basal rate that is increased or decreased from the pump programmed basal rate. In other words, Loop modulates the pump basal rate.
No matter how diligent the person with diabetes may be, it’s impossible to pay attention every five minutes to your ever changing blood glucose levels.
When dosing insulin, there are only two levers we control: dose size and timing. Dose timing is a big deal. I’m reminded of the bit of wisdom contained in the saying, “a stitch in time saves nine.” A well timed insulin dose will do the most work with the smallest amount of insulin. Anyone who has struggled to correct a very high BG will attest that it takes a lot more insulin to correct high glucose than it does to prevent it.
Loop’s ability to pay attention and act dynamically and appropriately every five minutes, even while you sleep, is what makes it a huge improvement over manual insulin treatment.
Does this make things any clearer?
There are both DIY and commercial products available. Here is a good summary of commercial systems.
I’m sending you some tight hugs. I hope now that your A1C is down maybe things will begin to improve for you!
THANK YOU, EVERYONE! I finally “get it!” Given how I cannot even find my cell half the time, I think I’ll be sticking with the devices that are already preprogrammed for me with the G6 and Omnipod’s PDM. They’ve enough flexibility for me and I’ve no need to create my own app, which I doubt I could do anyway! I really appreciate the time you’ve all taken to explain this to me, especially Firenza and Terry4. And Tapestry, thank you for the hugs!
I’m still going up and down but am still in the trial period of the first six months so I’m giving myself leeway for learning how to use the existing devices AND Triseba! The very idea of ME creating an app is hilarious! But I wish everyone well in their quest for perfection! Being a few points off is OK by me, having lived with BGs off by 100s for a very long time, and now, deal with the permanent physical damages that caused. The control I have now is almost perfect … for ME.
Again, thank you all!