Loop -- a dynamic answer to a dynamic problem


#21

I think it might even reevaluate the Loop every minute, even though Dex only updates its values every 5. At least, that’s how openAPS works.


#22

I am envious. There does not seem to be a similar option for OmniPod users. I have marked this day on my calendar. I will count the time until you switch to an FDA-approved AP.


#23

Do you think it will be short or long? The Loop AP I’m using today probably won’t be commercially available, feature for feature, for many years. I can customize my glucose target. The MiniMed 670 model, due out in 2017, does not allow for a customized target and instead is fixed at 120 mg/dL. I have a feeling that this performance gap will exist for many years.


#24

Thanks for the detailed update on your experience so far. I have most of what I need to try the PI version, just a lack of time ! This may help me with motivation to find some.

Just curious for you Terry, and others. Do you let your endo’s know you are using these homegrown solutions ? And if yes, what is their reaction ?


#25

I would bet $10,000 that it will not be in the next 5 years unless your current system fails and you cannot get it fixed.


#26

Same for Dexcom alarms. I would love to set my Dexcom high alarm to110 mg/dl. There should be a strict rule that government should not be allowed to protect us from ourselves. It does not make sense to me that I can buy a gun and kill myself (2/3 of gun-inflicted fatalities are suicides) but I cannot set my alarm to 110. I bet that you can tell how angry I am.


#27

It’s all balance, I guess. There should be some provision for us to get some latitude to customize. I guess that’s what the #wearenotwaiting movement is all about.


#28

I’ll know more in 2 1/2 weeks. I moved this year and I had to make an initial appointment with an endocrinologist in July for a December appointment. She works at a university teaching hospital clinic and also conducts AP studies and research for commercial APs. This will be a test for her but I expect she’ll be good with it. I will work hard every day between now and then to draw incredible repeatable normal glucose traces.

As far as the safety and risk aspect of using experimental devices, I offer this. I am more at risk not using the Loop AP than I am in using it. I live with type 1 diabetes 24/7/365. It can be dangerous and I’ve lived through every permutation of hypoglycemia.

The Loop AP is designed to fail safe. It is very conservative in its execution and when it fails it simply returns to the insulin dosing programmed into the pump itself. Many builders and designers have put their children on these devices.


#29

I totally agree. A two-tiered approach would be good.
Tier 1: FDA-approved. You have the right to sue.
Tier 2: Product comes with a big sticker that says: Not FDA-approved. You cannot sue for whatever reason. FDA would have no say whatsoever.
FDA would required to fund itself 100% from sticker sales.


#30

Wow! That’s incredible! I’ll be curious if this keeps up for the long-term (though I have no reason to think it wouldn’t). Having that kind of control would be amazing, period, but having it without having to make any decisions seems almost unbelievable.

This makes me want a Minimed pump. I’m on the verge of getting a Vibe, because my Ping is on its last legs (too bad none of the open-source AP projects work with the Ping!), but stuff like this seriously makes me want to stop and wait for even the semi-AP systems that are on the horizon…


#31

I am such an optimist, sometimes. I have high hopes for this system. Looks like today will be a 100% time in range day and that’s something I could only do a few times per month before this. I’ll still have to deal with site absorption failing and deciding when to pull the plug on a site. And the other things that can complicate the diabetes equation.

It seems to me that watching blood sugar and dependably responding with just the right countermeasure at just the right time, all day, every day, is a great job for a computer and a not-so-good job for a human!


#32

That’s amazing. :slight_smile: I’ve only had 100% in range perhaps two or three times in the year and a half I’ve had the Dexcom (and I’m positive that I never experienced it before that!). I hope it keeps up for you!

I think it’s also the sheer number of decisions the computer can make compared to a human. Even if I wanted to, I couldn’t evaluate my blood sugar and make decisions every five minutes around the clock.


#33

I had a great appointment with my endo a few weeks back. I proudly brought a diagram to explain how the system is put together, and how it works, and gave her a live demo of the Loop controlling my pump from my iPhone (for a moment I felt like I was a representative for the #wearenotwaiting community :slight_smile:) We had a good chat about the underlying algorithm and its assumptions, but I felt that was a bit over her head. She was thoroughly impressed and supportive, never raised any concerns other than not being able to bring this to her other patients, and she took my little presentation to show to her colleagues. I appreciated she did not forget to carefully review and comment on my other labs.


#34

I also get great night values with Loop. And throughout the day - when I do my carb counting correctly :slight_smile:
Since I started Loop, my Hba1C went down from 6% to 5.7%, which is not a huge improvement one may think, but I had almost 3 weeks of terrible cold before taking the test, which made my body completely ignoring insulin.

My endo was amazed by the sugar chart, he showed it to his student and said “This is a chart of a type 1 diabetic. Can you believe it?”


#35

So much fun to see your success, Terry!


#36

How long have you been using Loop, @BK1112? Thanks for your comment. I’m curious how my new endo will react to the Loop and its amazing numbers.


#37

Here’s the full day Clarity report from yesterday:

Time in range = 100%, time hypo = 0%, standard deviation = 15 mg/dL, average BG = 97 mg/dL

I am in awe of what Loop is doing for me. Here’s last night’s overnight line:

yellow line = 140 mg/dL, red line = 65 mg/dL

My CGM woke me up at 3 a.m. with a 64 low. I ate one glucose tab and went back to sleep. This low only lasted 20 minutes and bottomed out at 62. My morning calibration bumped up the Dexcom by 10 mg/dL, so the 3:00 a.m. low may not have been as low as recorded.

Here’s Loop’s activity overnight:

You can see that Loop executed many sessions of low temporary basal rates. If my pump ran as programmed then my total basal delivery from midnight to 7 a.m. would have been 7.1 units. Instead, Loop delivered 5 units. I’m thinking that this info suggests a reduction of the background basal rates in the pump.

It appears to me that I can enjoy these kind of results consistently. At least that’s my hope.


#38

Okay, now that’s very cool!


#39

FYI, the G5 transmitter can be queried any time for a real-time reading.


#40

I expect this will go pretty much like the CGM situation – once the technology provides access to hackers, the Community will provide superior, but riskier, solutions to those blessed by the FDA and offered by manufacturers.

The only thing holding the Omnipod back is the proprietary nature of the radio hardware and communication protocol. The next generation (at least so far) will be using BLE, same as the Dexcom G5, which will open it up to hackers.