Today marks my first anniversary of closing the loop using the do-it-yourself automated insulin dosing system, Loop. This is a hybrid system in that one must announce meals and tell the system how many carbs I’m eating and when. Loop examines the blood glucose level, insulin on board, insulin sensitivity, and carbs on board every five minutes and then decides whether to increase, decrease, or maintain my pump’s basal rate. Here’s my post about Loop from one year ago.
I am thrilled with the results Loop gives me. To compare my pre- and post-Loop performance I am displaying the Dexcom Clarity 90-day standard day report for just prior to starting Loop against the same 90-day period one year later.
As this graph depicts, one year ago I was struggling with a pattern of evening and overnight hyperglycemia. I was actively attempting to make changes to my pump settings, eating, and exercise habits to rein in these hypers.
This data set shows improvement in three of my four blood glucose goals: time in range, standard deviation and average glucose. My time hypo went up by 1% in the post-Loop numbers.
During this time my A1c improved from the low 6% range to the mid 5% range, my lowest A1c’s in 33 years of living with diabetes.
Adopting Loop was one of the best diabetes treatment tactics I’ve ever used. It ranks up there with using a CGM, insulin pump, and rapid acting analog insulins. It’s also comparable to changing my way of eating to low-carb, high fat. At this point, I would do everything in my power to stay on this system.
While my results have been measurably better, my overall effort has gone down. Loop’s overnight performance has been dramatic. I often wake up under 100 mg/dL (5.6 mmol/L) without any hypoglycemia.
I am covered by Medicare insurance and I am lucky to also be covered by supplemental insurance provided by my former employer. This insurance is not as good as the lettered (A thru G) supplemental plans except that it has been covering my CGM and supplies. I’m using the Dexcom G4+Share system and I’m hoping that not upgrading to the Dexcom G5 will shield me from Medicare’s rules against using any device other than the Dexcom receiver to display BG results.
Overall I am happy with Loop and my personal BG results would degrade if I had to drop it for any reason. I have purchased some old MiniMed pumps to serve as a backup if my current MM 722 pump fails.
I love looping and I’m hoping that any future replacement I make will be a step up in performance.