- Messages
- 153
- Type of diabetes
- LADA
- Treatment type
- Insulin
This looks interesting https://diatribe.org/jdrf-aims-make-closed-loop-more-customizable-interoperable
Sorry @ringi, I'm afraid (and I feel qualified to say this for reasons that will become obvious) that you have absolutely no idea what is possible."closed loop" will never work based only on current BG monitoring, as by the time BG has increased, it is too late to add the insulin. There will have to a way for the system to know what food someone is eating. Or a BM sensor embedded on the blood that leaves the digestive system.
Also, current systems add the insulin too far away from the liver to get a very quick response.
(We may get system where someone can take a photo of the food they are about to eat, and the AI works out the carb content etc.)
I can eat limited carb meals (less than ~40g carbs) without bolusing or meal announcing and stay in a range of 3.9-10mmol/l (70-180 mg/dl - the range used in clinical trials), and if I announce something like Fish and Chips, or eating out at a restaurant, then I don't have to bolus.
Again, an interface already exists, and we use it. It's simply IFTTT buttons configured for certain actions. They are on my smartwatch and I can tap them with food. I don't have to be massively accurate either.Low carb clearly makes the problem easier due to the "rule of small numbers" and slower changes in BG. I expect the key will be the design of a UI that allows people to announce meals that is easy to use, yet gives the system enough data to learn from. (One day it may be possible to measure the hormones that are released when a meal starts to be digested.....)
However I see most of practical benefits being from preventing hypos, as it is not hard for someone to press a button when they start eating, indicating if the meal is "low carb", "mid carb", or "high carb". I expect that sharing data between users (along with GPS) will help for larger restaurants.
(I assume a link to something like a fitbit and GPS is used to get input on exercise level.)
However I thought healthcare providers worldwide have refused to pay much more for "better" insulins, hence how will these new insulins be funded?
I just don’t like the terminology "Artificial Pancreas", as it makes people think they will be able to forget about diabetes and hand over all responsible for their health to the system. Even worse when they start to be used with Type2 leading to an even fasting cycle of increasing insulin resistance.
(It is a few years since I have written control software (mostly open loop), but I have worked on some large scale industrial control systems. Telling when a sensor is giving invalid data is always an issue.)
I think it's fair to say that if you operate fully closed loop, the results are not as good as the almost closed loop approach, but they are still good enough to achieve a surprisingly good hba1c for example!Thinking more about this, I think the issue I have is the concept of "closed loop", I have no problem seeing how mostly automated systems that are not complely "closed loop" can work.