Update on the iLet (bionic Pancreas)

Diabetes Technology Insulin Pumps
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You’re right, Medtronic no longer sells any of the compatible pumps for looping. I see pumps offered on a few Facebook closed groups including Looped and Type 1 & 2 Diabetes Support Group. You need to join these groups to see the posts but that is easy.

The Type 1 & 2 Diabetes Support Group has recently changed its name from a “pay it forward” group. Facebook has taken enforcement steps against activity trading prescription items and this group changed their name in an attempt to avoid further scrutiny.

These pumps are usually offered by individuals as a “one-off” transaction but some middlemen have started buying and selling pumps and taking large markups. And sometimes people pose as middlemen and their only intent is to defraud. If a member of one of these communities offers a pump for sale, it’s easy enough to search their participation history to see if they are sincere or just out to rip-off.

The buyer can protect themselves by using Paypal but avoid the friends and family transaction type. That will help recovery of funds if you end up sending money to a thief.

I see pumps regularly offered on the FB Looped site. Their policy is that sellers must post a price in the offer in order to prevent bidding wars. Sometimes I see pumps given away on this site. Unfortunately, at this time demand outstrips supply. If I were looking for a pump, one of the tactics I would use is to regularly participate in the Looped community to maintain an awareness of the pumps as they arise. I would also search CraigsList, too.

I think one of the most hopeful paths forward is using a brand new pump produced by SOOIL. This South Korean company produces pumps under the Dana brand. The company has been manufacturing pumps since the 1980s. These pumps are designed with open source communication protocol and can be used as part of a do it yourself system. Dana pumps are not available in the US yet, but people in Europe may buy them.

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79

Another option is to ask your endo/CDE. My endo had a 522 that a patient had turned in after upgrading to a new pump.

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This is fascinating reading. I have only ever been on Omnipod and don’t know anything else about pumping. I never really frequent the site but after 2 hours of reading i am blown away. Cheers

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You said, “There are pump systems today that can deliver what you would like.” But only if you can obtain a working, older, and correct model of a Medtronic pump. Good luck! And using Craigslist is a waste of time. Terry4–how can an an engineer who wants to start this project get started?

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It’s not easy finding a compatible pump for the do it yourself systems. But people continue to find these pumps. I see leads on compatible pumps regularly at the Facebook Looped group. I even saw one comment recently of a person who bought a brand new Dana RS pump on the international market.

I don’t mean to minimize the effort it takes to find a pump that will work but it can still be done. With your engineering skills, getting the pump will likely be the most difficult step for you to take. Good luck if you decide to go forward with this effort. I’ve yet to read of any significant regrets of someone who achieved building a system for themselves or their child.

SOOIL, makers of the Dana pumps, is in the initial stages of pursuing FDA approval for their pumps. I don’t know their timeline but approval of their pumps will go along way toward meeting the demand of the DIY loop pumping community.

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Is that the entire premise of the Dana pumps? Making a pump specifically for this sort of stuff? Or is that just a part of their intent?

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They have been making pumps for 39 years, so they are not new to the market. They are just the first to truly market to the looping crowd, and in a way we can control.
http://www.sooil.com/eng/product/

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As @Hammer notes, SOOIL has been making pumps for a long time. Appealing to the DIY demographic is just part of their design intent. Their Dana pumps work as a stand alone product. What’s new is that they have included as part of their design an open-source ability to wirelessly communicate with their pumps. It’s amazing to me that they’ve been making pumps for as long as Medtronic MiniMed has.

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The amount of things that have come across my screen (even prior to home computer use Terry) … and how I would build up my hopes … well … that’s life. I just know, I keep my eyes open … try my best uses the devices that “I” can afford (not all of us having lovely insurance for all these gadgets and are often just a pipe dream).

We can only wait … and yes on the Fiasp … the algorithm is very different for that (had tried it in my insulin pump last year … and now even using it instead of NovoRapid/Novolog to you in the US … is a learning curve.

All I can say … with the latest news from a study … I’ll keep on using my noggin’ to keep it alert … and avoid the ol’ A word that is associated with insulin, etc. etc.

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I saw this company way back in 2007 when I was attending an IDF (International Diabetes Federation). A T2D I was with - who I think was really LADA … was seriously wanting to go onto their system at that time. A very affordable insulin pump compared to the big bully in the room we all know about (I think some of you may know that I have met up with folks who have either died or are in coma’s do to that companies failure to own up to their devices). So, to get back to point, it’s been around for awhile … but like here in Canada … where we have a smaller population of insulin pumping diabetes … getting government approval (in our case it’s Health Canada) … well … it’s the waiting game.

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Diabetics can still produce glucagon unlike insulin so why the need to externally supply it

True, but the paracrine response between the beta cells (insulin) and alpha cells (glucagon) (and probably other islet cells) that is normally there is gone/disrupted. My guess (I am wont to make wild biochemical “houses of cards” based on very scattered knowledge) is that there may be a paracrine response where insulin secretion “sets up” the alpha cells for a glucagon response some time later (and maybe vice versa).

That would seem to naturally support a pulsatile/anti-symmetric insulin/glucagon response (signal the liver and fat to release glucose via glucagon, then signal other tissues to take it up via insulin a bit later). In diabetes (at least T1D, the alpha cells don’t get a signal “directly” from the beta cells, and are left “on their own” to respond to BG systemically, and probably neurological input (parasympathetic) and (wild guess) signals directly from tissues (a “we need glucose!” signal). A sort of “glucagon incretin system” (incretins increase insulin sensitivity, this would do the same for glucagon).

But those signals would be slower than paracrine signals directly from beta cells only a few tens of microns away. Systemic endocrine signals might also be “diluted” compared to paracrine signals, as they naturally dilute in the blood volume (doesn’t apply to neurological signals).

Having the pump give glucagon itself would maybe allow more “aggressive” insulin dosing. Say that 1 unit will produce a 2 point drop over 5 minutes, and a 20 point drop over 30, and you’re at 100. (I have no idea if these numbers are reasonable for Fiasp or anything else.)

A unit would be appropriate, as the drop of 30 would only take you down to 70, which is barely non-hypoglycemic. But it only produced a 2 point drop in the next 5 minutes, which is not optimal if you’re eating, say, a snickers bar.

5 units would drop you 10 points in 5 minutes (again a guess - it’s probably not linear), but over about 20 minutes it would drop you to say 20. That’s 100-5*20+10 Say the snickers glucose curve has a sharp spike, and then slow absorption between 5 minutes and an hour - this is the 10 point “fudge factor” (pun intended), and the sharp spike is assumed to be completely taken care. Again a numbers are a guess. This is clearly unacceptable.

But if you have glucagon, you give 5 units now, which deals with the sharp spike, and then a small glucagon pulse say 10 minutes later. That would give at (maybe) 100-(20/3) = 93 after 10 minutes. The glucagon raises BG a “bit” (no idea on the number so say trending on its own to hit 100 after 15 minutes. But the original insulin is still in there at 10 minutes, pulling it down to say 85 (+ or - however off my numbers are from reality).

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You obviously understand the human metabolism better than me. At this point, with 37 years of living with T1D, I am starting to perceive just how awesome a healthy metabolism performs.