Learn about Looping: The Do-it-Yourself Artificial Pancreas
I still get excited bolusing directly from my iPhone. You are right that is not available on any commercial pump. However, a do-it-yourself community of people living with type 1 diabetes have made an automated insulin delivery system that adjust basal rates every five minutes, allows remote bolusing from your phone and displays blood glucose data, active insulin and carbohydrates all in one place. Today, you are getting an introduction into Looping.
What is looping?
According to the main source of looping information—www.Loopdocs.com: “Loop is an app template for building an automated insulin delivery system. It is a stone resting on the boulders of work done by many others.”
In my own words, Loop is an iOS app (Apple only) that connects a continuous glucose monitor and a compatible insulin pump to your phone to bring automated insulin adjustments.
Equipment needed to get setup:
The biggest barrier to the current do-it-yourself artificial pancreas community is finding a compatible pump. Because of a ‘security flaw,’ software engineers discovered how older Medtronic pumps communicated via a radio frequency. As of April 2019, DIY Looping is now compatible with Omnipod as well. This communication protocol has been patched in firmware, limiting loopable pumps to the following list:
- Medtronic x23 series
- Medtronic x22 series
- Medtronic x15 series
- Medtronic x54 series (for our international users)
- Omnipod Eros
The most up-to-date list can be found here: https://loopkit.github.io/loopdocs/ under “gear”
The Riley Link is the hardware that communicates between the pump, iPhone and continuous glucose monitor. It is about the size of a tic-tac box and needs to be carried on you at all times. This seems like a fair trade for the ability to have an automated insulin delivery system.
An Apple Developer Account is required to install the “Loop” application on your phone. It is not available in the current Apple store.
As referenced above, a continuous glucose monitor is required. Loop can read CGM data directly from the pump meaning that Medtronic and Dexcom systems are compatible.
Any specific questions on requirements can be found online: www.loopdocs.com
How much does it cost?
If you have a compatible pump, the full cost to get up and running is $234 dollars. Here is it broken down:
- Apple Developer Account ($99 per year)
- Riley Link—communication device (available here)
Why use a do-it-yourself platform instead of a commercial hybrid closed-loop system?
Managing type 1 diabetes is a personal experience. Where Loop differs from current commercial systems is that the user adjust the various targets and inputs to meet their unique goals.
To put it more explicitly, if you want the system’s target to be 5.2 mmol/L95 mg/dL then that is what you can set it to. Experiencing too many lows? You can change this to a more conservative number like 6.7 mmol/L120 mg/dL.
Another great benefit is that you can mix-and-match brands i.e. use a Dexcom G5 and a Medtronic pump.
Finally, you may have all the equipment needed to have an automated insulin delivery system and can get set up for less than $250.
The benefits I have experienced from Looping
After 10 years living with this disease, I finally feel like there is a toolbox that can fit my management.
Before looping, my options were static and limited. The biggest pain point I struggled with was overnight highs or lows. Sleeping for eight hours with blood sugars out of range, and without the ability to correct, can mess up the entire next day.
Now, since looping, here is what I have noticed:
- Waking in range around 6.7 mmol/L120 mg/dl
- Visually see current blood glucose, active insulin and carbohydrates in one place
- Feedback on how many units of insulin the system used to cover a meal
- That others can be included in my blood sugar management because it is all available on my phone
Everyone needs to be warned that this new system 100 percent requires manual input and learning. What can be achieved is worth the effort.
This article is only to demonstrate what is already possible by using a do-it-yourself solution like Loop, openAPS, or AndroidAPS. I encourage you to watch the video, ask questions below and check out www.loopdocs.com for all specific questions.
The next Looping article will highlight 10 individuals who are on the system and how it is impacted their life.