openAPS: Ask and answer questions here!


#41

OpenAPS runs on a Linux computer such as the Edison board your have. To communicate with a pump, OpenAPS typically uses a Medtronic CareLink stick or a CC1111 USB stick. The Loop runs on an iPhone, and it communicates with a pump using a custom hardware board called RileyLink. These systems have been developed by highly dedicated and motivated people who have volunteered countless hours and substantial expertise into these #WeAreNotWaiting projects, and have made them open and available for anyone to inspect or put together and use. It should be understood that none of these do-it-yourself options are ready-to-use products with polished documentation or commercial-grade technical support.


#42

Yes, I borrowed an older MiniMed 722 pump for this. It’s my understanding that the Animas Ping is a more difficult APS project at this time.


#43

I have a new question !

I have started the setup for OpenAPS, using Raspberry Pi, MM522 and Dexcom CGMS. I plan to use primarily for night time, to reduce alarms and get better sleep. I don’t own a smartphone, and no interest in access while out of the house.

My question is whether I also need to set up Nightscout (uploader) for OpenAPS to work ? Nightscout is frequently mentioned, but not clear if required.

For example, this is posted in article by Dana Lewis:
"The basic idea of the system and physical components are a Raspberry Pi (credit card-sized computer), a Medtronic Minimed pump, a Dexcom CGM, and a Nightscout uploader. "


#44

You can setup OpenAPS using only RPI (or an alternative computer board), a compatible MM pump, and Dexcom CGM. However, it is highly recommended that you also setup Nightscout for visualization purposes. Without Nightscout, it is more difficult to see what the system is doing. In general, for any technical questions related to setting up or using OpenAPS, I’d highly recommend posting questions in this gitter chat room: https://gitter.im/nightscout/intend-to-bolus


#45

Thanks Dragan1. Will do.


#46

I’ve been looping with both OpenAPS and Loop since August. It’s been a voyage of discovery, but the biggest thing it gives you is time. Probably the best analogy I can give is that it’s like Sugar Surfing without ever having to check your CGM. I’ve written quite a lot about the experience as it’s something I think is worth sharing (you can find that here, but for those who are not sure what to go for and how to set it up, there’s also a guide to the different systems. I’d recommend, if you have an Android phone, looking at the Open Loop system HAPP first, to get some idea of how the loop algorithms work.


#47

Would love to hear about how you are using both simultaneously. We’ve been using openAPS since about August too, but we recently set up Loop, mainly so that I can have a remote bolus for my son and not have to fish his pump out of his belt pocket. Right now we’re running Loop only as a remote bolus but not a closed loop.

I’m still trying to figure out how they interact and whether the settings in one can lead to wonky effects in the other.


#48

How remote? Is this locally done, or through the cloud?


#49

At work, I’m not allowed to use my phone, so the phone sits in a pocket and I can use my medical device (i.e. the pump) and NightScout for to run OpenAPS. Then, when I go to meetings, go home, etc, I run Loop for its portability. This generally includes client dinners in the evening. You become very familiar with how both work in this scenario. As Loop now allows carb data upload, OpenAPS has a good enough history to work with.

I’ve run them side by side (with both communicating with the pump) and aside from the pump comms errors that occur, it also clearly demonstrates the difference between the static absorption curves and how AMA works. But you get better results only using one, so I wouldn’t recommend using both simultaneously. I’ve also run them side by side with each taking the glucose data and speaking to different pumps. That’s also an eye opener in terms of how the two predict slightly differently when looking forward.

As it stands though, I’d suggest sticking with one and then getting to know it really well.


#50

remote in the same way that, say, an Animas ping is remote. It talks via Bluetooth as far as I can tell, so if you’re within, say 30 feet of the person, it usually works. Cloud would be way more helpful for me because I wouldn’t have to go to school for lunch, but it would also be a lot riskier. We looked at setting up code for an SSH-based remote bolus that would work via the cloud, and there was so much interference in the communications that it did not seem robust enough. We basically had to turn off openAPS to make the SSH work. We never actually tried it on our son as a result, just seemed too flaky.


#51

Thanks for the reply. I was also thinking along the same lines–lunch bolus while at school.


#52

You know, I’m sure it’s possible. If your child is older and you have a nurse and some way to confirm the bolus (it should show up in Night Scout), then it might not be as risky. The code itself is not super sophisticated. And I know from images on CGM in the cloud that someone out there initiated a text-based bolus operation, so you text the phone and somehow deliver a bolus, and it sends a confirmatory reply. So, no doubt, theres a way to get it done. It’s just that our son is 2, and the caretakers responsible for him are not trained on his pump or insulin dosing (just lows) and have 10 to 12 other toddlers per teacher to monitor, so we didn’t feel there were enough safeguards in place. But I could imagine a relatively safe protocol for robust remote bolusing. You text the caretaker that you’re delivering the bolus, it shows up on NightScout, and your son or a nurse physically looks at the pump to confirm the last bolus. If you don’t get a confirmatory text & the NS update in 5 minutes you follow-up with the nurse/teacher responsible.


#53

Wow. I haven’t heard of a text-based boluses before. My son is 4 and uses Omnipod–largely for the benefit of remote boluses. We are debating on home schooling or not for the sheer reason that we will be out of control. There is not much education in the school system–even among nursing staff (liberal use of glucagon). If we could implement Loop or OpenAPS with the ability to remotely bolus, it could be a game changer. All we would need a nurse to do is to verify carbs eaten. Thank you! Do you know where I could get more info on text-based boluses?


#54

Bradford1, I couldn’t find the link where someone posted a picture of his remote-bolus enabled system, but it was in this CGM in the Cloud Facebook group.
https://www.facebook.com/groups/cgminthecloud

I understand the desire to homeschool because of this, but I honestly think if you set up and implemented a closed loop and made sure the settings were pretty well-tuned, it would radically open up the options. Because anyone can learn to become comfortable delivering a bolus given some instructions, and because the loops can correct for bad/mistimed boluses, so the nurse in charge just has to learn how to use a basic app. If you don’t mind my asking, what are the worst case scenarios you are worried about? And do both of you guys work outside the home currently?


#55

By the way, my husband set up both openAPS and Loop,and Loop is extremely easy. Basically it took a few hours while my kids were napping. openAPS took him several weeks of working overnight, but I think it’s substantially easier to do now because they’ve really streamlined the instructions.

The main thing is you’d need to find a pump that is compatible with openAPS, and for Loop you need an iPhone (and reasonably speaking, a Mac since you need to renew it every few months I think).


#56

@Tia_G OpenAPS now takes about 10 minutes, as long as you have the appropriate hardware to build it on. It’s very simple. Setting up the Pi or Edison probably takes the longest.

The text based boluses was something that was set up on either AndroidAPS or OpenAPS as a proof of concept.


#57

Do you happen to know how set it up?


#58

My biggest fear is that a bolus would be given incorrectly and he would go too low. I work outside the home, and my wife used to be a school teacher (in several districts)–but now tutors so she could stay home with the kids. My wife has told me numerous horror stories from different schools on how they manage T1 students. Aside from being a social pariah (excluded from classroom treats), there have many different scenarios that concerned me. One student was given 10 units instead of 1 unit, one student was covered for the wrong meal or not at all. These incidences have caused school staff to undercover meals to be “on the safe side”. Glucagon was given routinely. Scary stuff.

One question–what is your experience with a 2 year old with a tubed pump? Is it harder when playing? Snags or unwieldy? Ok. more than one question. :slight_smile:


#59

Sorry, no. No idea. And the guy who did it had set up a bunch of safeguards, including such things as dual factor authentication, checking delivery, etc. It wasn’t simple.


#60

Hi Bradford1, so regardless of whether you implement openAPS in closed loop mode I would really explore whether to set it up, if only to use Night Scout for school. Because every action taken on the pump shows up on your chart, both in the reservoir volume and in an actual bolus that displays like a dot on the chart. I’m including a screenshot so you can see the data that’s available. Those little dots? Those show how many carbs were given or how many units were delivered. The number by the Pump box on the upper left shows the units of insulin left in the cartridge (so you can back calculate to see if a bolus was delivered), and it also shows the battery life. Some show how many carbs were delivered. As you can see, our son is having a run of nasty lows the past few days :frowning:


If someone overboluses, you can see it ASAP. And if only about a third to a fourth of the insulin begins acting in that first hour, that gives you time to get over there and begin pounding the skittles/jelly beans/etc. to counteract the overdose. One time we had a pump malfunction where our son, who is normally given about 4 to 5 units per day at that time, got somewhere between 7 and 20 units. We managed to avoid the glucagon scenario by stuffing him full of food for hours on end, but the reason we could avoid a cataclysmic emergency is that I’m so close to school so could rush over the minute I saw his morning bolus was acting very funny. So it is super scary that happened in your school district.

The tubed pump is sometimes a pain in the butt (literally – potty training, etc.), but honestly our son is fine with it and seemed to prefer it over having the large, bulky OmniPod cartridge attached to him (at least, based on the free pod we tried out one timel). Every few weeks he may dislodge his site while sliding down a slide, wrestling etc., but for the most part it is not a huge hassle. And we like that, because he uses such low doses, the cartridge doesn’t have to be changed every three days.

The tubing is less of an issue than is the need to constantly fish the pump out of his SpiBelt for boluses while he’s running around. That’s why I’m ecstatic about having Loop – even if we don’t run it in closed Loop mode, just issuing the manual boluses while standing far away from him is huge. We initially had an Animas Ping because of the remote and giving up that remote for openAPS was tough for me.