Loop -- a dynamic answer to a dynamic problem


#142

Your membership in the diabetes club should now be revoked! :slight_smile:


#143

Here’s an update for the last 30 days – December 26, 2016

Loop continues to perform with few glitches beyond the slope of my learning curve. It’s brightest appeal so far is getting me dependably through the night, though it’s not perfect. If I drift above 150 mg/dl (8.3 mmol/L) it doesn’t seem to be able to reel that in. But when I can start the night in the 65-130 mg/dL (3.6-7.2 mmol/L) range it seems to be able to hold a good line. Waking up under 100 (5.6) is nice and happens more frequently now.

108 mg/dL average = 6.0 mmol/L

I’m still using Afrezza 4-unit doses to knock down trending highs. I can usually hold them below 150 mg/dL (8.3 mmol/L).

I’m getting better results with less effort – better quality of life.

I hope you are not tiring of the continued reports!


#144

Thanks for keeping us updated! I like to keep updated on strategies that others are using even if I’m not using them myself. I hope Loop continues to work well for you!


#145

I for one am very interested in your closed loop results. The results ate impressive, too, with nearly a flat line. We all know how very difficult that is to achieve. I’m able to mostly stay under 140 but I can’t seen to manage the lows very well. I think the closed loop could really help with its algorithm predicting lows and executing reduced temp basal commands. I’m using the open loop for that but it is tedious since it is all manual. Thanks very much, @Terry4 for keeping us updated. It is very inspirational.


#146

I simply can not wait for superultraextremehyperturbofast insulins.

This will have the biggest impact on these systems.


#147

@Dave26 – When I first heard that the DIY APs simply altered basal delivery, I was skeptical as to its potential. Now that I have a front row seat watching Loop do its thing, I am amazed at how quickly it senses a trend change and acts just as quickly. If a real trend does not ensue, the program gracefully changes its mind and reverses direction.

While we humans tend to think of an insulin dose change as one with a fairly long life (at least one hour) and inappropriate to change direction too quickly, the algorithm revisits all decisions every five minutes and without pride, will change its course.

Faster insulin with a shorter duration (like Afrezza!) would definitely help, as would shelf stable glucagon. Temp basal rates is not the tactic I would have chosen but I now appreciate the safety, wisdom, and unexpected efficacy.

While these early hybrid DIY AP systems will get better, they are already much better than I had hoped.


#148

What we need is a better delivery system. I would say much of the time is spent waiting for the insulin to absorb. I know that the Viacyte system relies on blood vessels growing throughout the mesh–giving direct access to the blood stream. Maybe a capsule with external port could serve as intermediate until these fancy home-grown islets are worked out.

Love your posts @Terry4!


#149

Blood glucose gains sustain

I’ve been looping for a little more than 60 days now. Looking at the side by side last 60 days versus the prior 60-day period shows a major change in trends.

Prior to the Loop run, I had been struggling with overnight highs. This had been going on for many months. You can see how well Loop tamed the overnight BGs into a narrow in-range channel. I still have to fight a tendency to go high in the evening. but not as bad as the previous 60-day period.

Here are the numbers

Everything improved in the latest 60-day Loop period: time in range went up, time hypo went down, variability went down, and the average BG went down, too. My four most important measures improved. I’m liking this.

I’m using the Loop variable temp basal rates as my primary tactic. I use Afrezza to knock down trending highs.


#150

Impressive! I am not even close to that kind of stability, despite Loop.


#151

I’d be happy if my daughter’s graph looked closer to even your “pre-loop” graph!


#152

Taking nothing away from the amazing progress Loop has made, keep in mind that @Terry4 follows an LCHF diet pretty consistently too, which helps.

@rgcainmd, I suspect that if your daughter ate the same diet, she’d have better results too. However, she’s a teen, and regular doses of Pizza are not on the diet :grin:


#153

I know. My son’s A1C briefly dips down to something approaching that low for a few fleeting 2-week spells, but the only way it would look that flat and universally in range is if you zoomed WAAAY out and set the high and low thresholds at 20 and 400.


#154

The important thing for you and your son is that you are doing the best you can to make things better now. Your son will grow and the diabetes game will change with that growth. The things you’re learning now will inform that sixth sense of treating diabetes from which you will make wise choices. You are committed to this project, heart and soul, for the duration. There will come a time when it dawns on your son how much you gave of yourself for his benefit. Persist. Endure. Better times will unfold.


#155

I was diagnosed at the age of 30. Before that, I went through a rebellious teenage period. If I had diabetes during that time, I would have been lucky to escape with my life! It took me many years of living with diabetes to finally take ownership of it. I think a lot of young-adults with diabetes diagnosed in childhood come around to accepting their situation and start making better choices in their 20’s.

The trouble with these graphs is that they invite unfair comparisons. It’s not intended. I’m sorry for that.


#156

On the contrary, I think they fill us with optimism for what is possible.

You know, @Terry4, my psych state was not that great, as a parent of a T1D, when I encountered the Flatliners thread. it made a big difference to my son and to me, to know what is possible.

Our kids are less vulnerable to damage early on, and we know they are in for a rough BG ride until they stabilize post puberty. I keep my fingers crossed that mine does not become too self-destructive as a young adult.


#157

When this knowledge washed over me, I was moved that any PWD could trace normal BG lines. Knowing it was possible instantly won my heart. I’m glad it’s helping you. You and your son are an amazing team. I wish you many victories against the evil-D.


#158

Wow. Remember that time you had diabetes?


#159

Thanks for the thought! As much as I like to celebrate good diabetes numbers, be assured that the evil-D restores my humility on a regular basis.


#160

I am loving this thread, @Terry4! Thanks for sharing your experience.

This is probably a stupid question, but why don’t you just change your regular basal program?


#161

I think of my pump basal program as the median of my basal needs. My actual basal needs will vary day-to-day above, below, and at times right on that median. The job of the Loop is to make basal adjustments that will send my blood glucose closer to or even into my stated BG target range.

In other words, the pump basal program should put you close enough to your ideal BG range so that Loop can close the final BG distance automatically.