I came back here looking for an old friend that I lost contact with, unfortunately, he doesn’t seem to be active here anymore.
I know some people have very good results with the commercial systems. For the average diabetic, systems like TSlim can greatly reduce the burden of Diabetes. I wish every diabetic on the planet had access to a commercial system like that.
For me personally, with my targets, my A1C would be about a full percent higher unless I played games with fake entries and keeping it in sleep mode. Mind you, a 6.0 A1c is nothing to sneeze at. 98% of Diabetics would be thrilled with, and much better off with, that number.
DIY systems aren’t for everyone. Insurance doesn’t cover the cost of your phone, developer accounts, hardware etc. Also, very few doctors will support it. Mine gave me the FDA letter against DIY systems the first few visits after that letter came out. I have to ask her specific questions about settings, she won’t look at my Loop settings directly and make recommendations, I have to ask about specific issues. So, much of my settings support comes from my own learning enhanced by the volunteers in the community groups (not doctors). I am dealing with the challenge now of finding a new endo in VA that will be willing to take a DIY looper, many will not.
I do feel much better when I am on a low carb diet. The whole pandemic, layoff, year out of work, 6 months with Long Term Covid, moving all the way across the country for a new job etc, pretty much killed any kind of eating plan, or exercise, or anything else. Now that I am finally settled into my new job and my new home in VA, I hope to get back to paying attention to things like Diet, but there are still the pandemic challenges related to the supply chain, simply buying a deep freeze is a challenge for example…
Forgetting to bolus for a Taco, having Loop recognize that and correct to keep me under 160 without going low, I find that priceless. Getting a real soda instead of a diet soda in a drive-through and having Loop recognize that and keep me in range, priceless. Not having lows anymore (as long as I have a good sensor on, there is still that challenge), priceless.
The out of the box solution, 24x7 support, an Endo helping with settings, a warranty, those things are priceless for most people. Those people SHOULD stick with the commercial systems.
My unofficial understanding from off-the-record discussions is that none of the commercial systems will allow a low range below about 110. Of course, that could change as they come to market. No one really knows for sure until it all gets past the FDA. My day time range is 78-88, I don’t see any commercial system allowing a target like that. What I don’t like about some of the commercial systems is that they hide the algorithm from the user. You don’t have any way to know or understand why it is doing what it is doing. It is just a magic box, making decisions for you. I personally think the user still needs exposure to what the box is thinking and doing on your behalf, even if many people seldom or never look at it.
The CGM companies benefited or suffered, from the DIY community, depending on how you look at it. Without NightScout and the #WeAreNotWaiting community, I doubt that Dexcom follow would have ever come to market. Dexcom now appears to be dialing that back and trying to restrict access to our data, we should be angry about that (but that is a whole nother topic).
The pump companies have also made changes, I believe because of trying to catch up with the DIY communities. They are having a harder time of it because of the FDA.