Tidepool loop

I have no idea why I need to understand this. I sort of get it but can any of you, learned ones, explain this bit more easily?

https://www.tidepool.org/blog/tidepool-loop-dexcom-g6-collaboration?mc_cid=0b9aca3e6f&mc_eid=83369cc79a

Ok, so here goes…

Tidepool is a free software package that displays all your BG data, Pod change data, etc. It is free. It is not open source software. That means you can use it, but you can’t reprogram it to change how it functions or customize it.

Tidepool has partnered with Dexcom, Omnipod, and Medtronic. Loop is an open source software tool that builds an Automatic pancreas on top of your pump. It is the combination of work by openAPS, Nightscout, Tidepool, OpenOmni, abd all those diabetic hacker groups.

Everyone who is using Tidepool is donating their patient data to those groups so that they can build better algorithms. I think that TP is a ‘big data’ effort to give researchers and commercial companies more data so that they can build better products.

This is what my data looks like in TP:

The data provided by Loop users is being sent to researchers and Loop algorithm is currently under FDA approval. Omnipod also has an algorithm in FDA. So, in summary, its an effort to get Artificial Pancreas algorithms through FDA.

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Hi. Thank you very much.

The data provided by Loop users is being sent to researchers and Loop algorithm is currently under FDA approval.

Can you explain this sentence to me please? Specifically why does the FDA have to approve this? I guess they have to approve everything new like this.

For what purpose?

And how does one access and use tidepool?

I will research that also.

Pod change data. That does not apply to the Medtronic 670G pump. Correct? Or maybe it does.

Will this affect sensor use?

Also is Tidepool what the endocrinologist uses to get info off my husband’s pump? I don’t think so but maybe.

You can see I don’t know enough but am trying to learn.

Want to support my husband as much as I can. I am the researcher in the family.

Thank you again.

Sally

This isn’t going to have anything to do with the 670g. The Dexcom/Medtronic partnership will most likely be implemented after the 780 comes out, you’re looking somewhere in the neighborhood of at least 5 years before you see a Medtronic and Dexcom pump system.

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Wow. Long time. I would still like mohe to answer my questions. Ty.

I didn’t want you to get your hopes up of Dexcom and Medtronic partnership happening in a short timeframe. The reason tidepool is going through the FDA is because Dexcom/Medtronic want to use their algorithm. Both companies cannot sell their products without FDA approval, they have all the liability unlike DIY loop systems, which have no liability with their system.

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Don’t know what I would do without you.

I am not diabetic but have been married to a wonderful man who has had diabetes for over 50 years.

As a librarian and being the researcher in the family and my husband has visual issues not related to diabetes I try to keep up on things related to his health. Even things that come down the pike. It is difficult for him to spend a lot of time reading.

And I find the future is a conglomeration of terms that have come before and I must learn them to understand future terms.

Jason, Can you tell me what you mean by DIY loops systems?

The DIY loop systems are algorithms written by individuals who hack the systems of Dexcom, Medtronic and OmniPod to make those systems do whatever they want. They are not FDA approved, are essentially illegal. The developer of such systems carry no liability and no responsibility if someone dies from using their product, unlike the companies mentioned above. Fortunately, Tidepool does want to partner with the major players in the field, they are looking at getting FDA approval. The Medtronic/Tidepool Dexcom partnership is something to look forward to. I believe Tandem’s loop system which will launch in a few months, is going to be a game changer in the loop ecosystem. I wouldn’t turn my nose up at a Medtronic/Dexcom partnership.

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Sounds good.

I understand.

Well thought out. Partnerships are good!

So, diabetics use Tidepool. Then, all the data goes into one place and sits there where researchers can access it.

Your 670g makes guesses about how to deliver insulin. It guesses how much insulin it should give. It does that using math. I use a system that operates using different math. That new math is being investigated by FDA.

Researchers can use TP to look at a bunch of different algorithms/math and see which are working the best. FDA will look at the math and see if it agrees that it is helping. FDA could say it is making things worse. Then, the algorithm would not be approved and Medtronic and Omnipod wouldn’t use the algorithm. They would try to make a different algorithm work.

I had to google this - it looks like you can upload 670g data into TP. If you put a doctor onto your tidepool account (using their email) then they can view it there.
https://www.tidepool.org/blog/tidepool-supports-medtronic-630g-640g-and-670g

I expect that you can see pod change data there if you plug in the pump and upload the data into the computer.

If you want to set up an account on your laptop/Desktop, you can do that here: https://www.tidepool.org/

@Sally, your husband is lucky to have a researcher in the family who takes an interest in his diabetes health.

The FDA has set up the regulatory structure to pave the way for interoperability of various pumps, CGMs (continuous glucose monitors), and algorithms. Up until this point, diabetes tech companies often pursued market strategies that bound their users within their tightly controlled ecosystem. People with diabetes, however, often found themselves using pump brand A but preferring CGM brand B and finding that these two different brands cannot integrate with each other.

This FDA policy will permit pump A being used with CGM B under the direction of algorithm C once all those components are approved and in place.

Tidepool (I deleted the space within your topic title, “tide pool,” to enable future searches to find this thread), a non-profit agency, has decided to take the DIY (do-it-yourself) Loop algorithm and use it as the starting point for the eventual submission to the FDA and hopefully the award of the iController designation (the little i stands for interoperabe). Just to be clear, the algorithm that will be submitted to the FDA for review and possible approval is Tidepool Loop and will differ from DIY Loop.

As part of that project, Tidepool has arranged with the Jaeb Center for Health Research to conduct a study of current DIY Loop users, including Medtronic and Omnipod pump users, to develop the data that will be used to earn the FDA iController certification. As a Med-T DIY Loop user, I have been participating in this study since early this year.

Tidepool has also produced a web-based analysis software that accepts data uploads from many pumps, meters, and CGMs. This software is free to use and some doctor’s offices use this for their clinic visits.

Good luck with your effort to become better informed about diabetes. This site is a good one to learn more. You may want to review the pinned post about diabetes acronyms. We use a whole bunch of alphabet soup abbreviations that can make it hard on those new to this area of interest.

Edited to replace iCGM in two places with iController.

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So grateful for this info.

Having been married to David for 37 years I have learned tons. Have probably studied more than David, actually.

Some of it very scary. The lows etc.

I do my best to take care of him as he does me.

I will continue to learn from all of you.

:heart:

In the quiet of the nite with no distractions.

Mostly after getting my head quieted I will read thru all of this again.

Much thanks❤️

Sally

We appreciate the effort it takes and all that you do to support your husband.

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Welcome, and keep asking!! The questions and answers help you and many others that use this site.

I have had T1D 50+ years, the first 25 pretty basic treatment. But once I started CGM, I needed help and found it here and other sites. Not just the mechanics, but how to USE the data and my pump for significant improvement.

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I have Rheumatoid Arthritis and my husband does tons to help me and shows great concern.

I do not have the steadiness and energy I once had.

So I appreciate all he does for me.

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Can you tell me what you mean by DIY loops systems?

First let’s start with “looping” or “loop systems”. A loop system has three parts. You know about CGM, like Dexcom CGM, which sends the glucose number to a phone every 5 minutes. That’s the first part. You know about pumps, like the Medtronic 722, or like the Omnipod, that can be told to give exact amounts of insulin whenever you want. That’s the second part. Well, suppose you could put an automatic controller in the middle (that’s the third part). It watches the CGM numbers every 5 minutes, and if it sees the glucose rising (or falling), the controller tells the pump to give a little more (or less) insulin. When the pump gives the insulin the glucose stops rising, and that shows up in the next CGM numbers. So that’s the loop: CGM number affects the amount of insulin, and the insulin affects the next CGM number. Little adjustments every 5 minutes, always steering the blood glucose in a good direction. The computer program (“controller” or “algorithm”) that figures out how much insulin the pump should give based on the CGM reading, that’s the third part of a loop system.

Some pumps can be told to dose insulin by a nearby remote control, rather than by pushing buttons on the pump. If the radio commands to do that are not complete secrets, and have been figured out by smart members of the public (the good kind of hackers), then that’s a loopable pump.

So a few years ago some people decided that #WeAreNotWaiting for the pump manufacturers to build really good loop systems and get them passed through the FDA approval process. Instead, they wrote a “do it yourself” loop controller program that runs on a phone or a tiny pocket computer, and listens to a CGM, and sends insulin commands to a loopable pump. That’s DIY loop. It would be highly illegal to sell a DIY loop system to someone, because it’s a medical device not approved by the FDA. But there’s nothing wrong about writing some software for your own use. And there’s nothing illegal about posting your own software on the internet for other people to use. Which the #WeAreNotWaiting folks did. So now anyone who has a loopable pump and a suitable CGM can go on the internet, get the software, and use it themselves, thus becoming “loopers”.

There’s an organization called Tidepool that got the LOOP controller software off of the internet, and is working with the FDA to figure out a way to get it FDA approved with all the necessary safety features. Some medical companies have gotten involved in this, either because they want to help the people who would like assistance looping (and maybe sell more CGMs or pumps), or maybe they want to be involved because they are concerned that DIY loop is competing too strongly against the company’s own proprietary closed-loop system, and they want to slow down the competition from DIY loop by getting the FDA involved.

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Excellent info. Thank you.

Try androidaps DIY. Much further along than tidepool and not for profit.

Hey @Flynn_Simon , can I ask you something?

Do you know if any of these systems are somewhat modularized - where I could pull pieces of functionality in and leave pieces out?