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.