JDC Gems

7. Device Update

DIY Closed Loop System
     Advancements in the existing technologies such as Continuous glucose monitoring (CGM) and insulin pumps led people with type 1 diabetes (T1D) and caregivers to monitor the glucose levels continuously and more precisely. Yet, the slow progress in its innovation and implementation made people with diabetes restless and the aftereffect of it was the emergence of an OpenAPS “#WeAreNotWaiting” diabetes community with patient designed closed loop systems.

     OpenAPS or the DIY closed loop system is a simplified Artificial Pancreas System (APS) designed to automatically adjust an insulin pump’s basal insulin delivery to keep blood glucose (BG) in a safe range overnight and between meals. The patient-driven research product is devised by pairing three components: a small computing hardware, open source software (OpenAPS), and an existing diabetes devices such as continuous glucose monitors (CGMs) and older insulin pumps. It works by communicating with an insulin pump to obtain details of all recent basal and bolus insulin dosing, by communicating with a Continuous Glucose Monitor (CGM) to obtain current and recent BG estimates, and by issuing commands to the insulin pump to adjust insulin dosing as required.

     Among the first 40 OpenAPS users, 18 respondents, 67% male, 61% adults, median 27 years old, 15 years with diabetes, 10 years on pump, 3 years on CGM were surveyed on quantitative and qualitative measures of their experience using their self-built artificial pancreas systems (APSs). The survey reported that while using OpenAPS, self-reported median HbA1c dropped from 7.1% to 6.2%, and median percent time in range (80-180 mg/dL) increased from 58% to 81%. About 56% reported a huge improvement in the quality of their life. The patient community has valuable insight, data, and experiences that can help device manufacturers, health care providers, and patients to place the next step in building better tools to better manage life with diabetes.

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