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Show HN: GlycemicGPT – Open-source AI-powered diabetes management

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Re: Show HN: GlycemicGPT – Open-source AI-powered diabetes management

#61

Post by jlengelbrecht »

M0r13n wrote: post #40

I don't think that LLMs are trustworthy companions in managing a complex metabolic disease like diabetes - especially if you deviate (ever so slightly) from the norm (very lean, very active, strict diet, etc.)! I'm a T1D myself and like to experiment with ChatGPT (or Opus). My experiences are mixed LLMs are overly cautious when it comes to correcting with insulin. They regularly advise against correcting before going…

Really appreciate this feedback. Every failure you named is real. I have had similar experiences with ChatGPT giving me bad information. I plan on solving for this by expanding on the RAG system that's being used. The AI gets its context based on settings you are giving it. The platform has some settings built in around insulin types but this needs to be expanded. The platform is not designed to give you dosing recommendations I really built this to help you understand your own data so you don't fly blind. Any thing the AI says to you is clearly labeled as not medical advice and the expectation is that your medical provider is in the loop before you make any medical decisions. I will take your feedback into consideration as I continue to explore new ways to shape the output you get from the platform.

Re: Show HN: GlycemicGPT – Open-source AI-powered diabetes management

#62

Post by jlengelbrecht »

Kryscekk wrote: post #46

As a urologist who built and runs his own clinic management software, I'd encourage thinking about this question early: what does the system do when the LLM refuses to answer, returns malformed JSON, or hallucinates a glycemic value? In medical contexts, a 'silent failure' (system continues despite bad data) is much worse than a noisy failure (system stops and asks the user). The 'happy path' for an LLM-powered medic…

Thank you. Really appreciate this feedback. I am actually already thinking about this. Hallucinations need to be clearly called out which is important. This is on the project's roadmap for me to address. There needs to be a way for users to clearly say "This is wrong. you need to reevaluate" In terms of alerting this is where we drift from what the LLM does and what the platform does. The platform already ingests data and stores it in the RAG system which provides the AI context but AI is the component that used for chatting about your data and providing you daily briefs. Alerting lives on the platform side so the AI may use it when we start implementing pattern detection to alert diabetics and care takers with questions such as "I see your glucose is rising. Did you eat and not bolus?" but for actual glucose events that fire during hyper or hypo events this is hard coded in the platform itself.

Re: Show HN: GlycemicGPT – Open-source AI-powered diabetes management

#63

Post by jlengelbrecht »

emsign wrote: post #15

FDA approved?

No but the project has undergone an in depth evaluation from Open Collective prior to being accepted for fiscal hosting. Additionally I am in contact with an Attorney who is reviewing the projects stance. The project as it is right now is aims to not cross any boundaries that would make it a medical device. The platform does not control insulin or make dosing recommendations. It's still in early alpha but I have made my position clear. The platform serves as a tool to help you understand your data and help you have better discussions with your medical provider.

Re: Show HN: GlycemicGPT – Open-source AI-powered diabetes management

#64

Post by jlengelbrecht »

surgicalcoder wrote: post #3

I'm a T1D who has an insulin pump looping with AndroidAPS and NightScout, what does this give you that Nightscout and Autotune doesn't give you? And how do you deal with AI hallucinations?

If your already using AAPS and are happy with it then my honest answer is you don't really need this unless you want to get the data analysis layer. What you would get is AI analysis of your data, daily briefs, alerting, etc. I have written an honest comparison to other OSS tools today. This should provide some clarity on what this is and isn't. Let me know if you have any suggestions or ideas on what would make what I built more useful to you as am AAPS user. Happy to hear how the project can adapt and grow and fit into your usecase. - https://glycemicgpt.org/docs/platform/concepts/relationship-...

Re: Show HN: GlycemicGPT – Open-source AI-powered diabetes management

#65

Post by brookst »

pu_pe wrote: post #22
AnthonBerg wrote: post #17

Earlier quoted context omitted.

My experience is completely the opposite, of using LLMs to pattern match and cast diagnostic nets. Is your perspective based on, say, opinionated principle?, or experience? The benefits are enormous. The risks; What risks? No diabetic with baseline adult competence is going to drive their insulin-delivery vehicle off a cliff because some app said so.

Risks: Changing parameters on the insulin pump because the LLM said so Neglecting to seek actual medical advice believing a LLM replaces it Misunderstanding medical complexity (ie a prescription due to medical history not available to the LLM)

Are those different from the risks of reading about diabetes on Reddit or using Google?

Re: Show HN: GlycemicGPT – Open-source AI-powered diabetes management

#66

Post by tornadofart »

pimeys wrote: post #52
tornadofart wrote: post #8

I'm a T1D and tbh it's not that hard to manage, I just wouldn't need that. But for kids or the elderly, I see a use case. The hardest to learn was that an unhealthy lifestyle resulted in a diabetes that was harder to manage. Too much carbs, not enough exercise, etc. After adjusting my lifestyle, it became quite easy. The most pain, in my experience, comes from the discrepancy between the CGM - measured value and the…

I don't know, Dexcom G7 is accurate enough. I do random tests from finger and it's about there a bit off but close. The previous versions were wildly off if you're having a hyperglycemia, and also G7 doesn't peak as high as measured from a finger. But in that level you already have ketones in your blood, and insulin resistance, and a bit extra insulin from the pump will not drop you to hypo.

Dexcom G7 has had inaccuracies for me. A standardized product meets non-standardized living beings, I guess.

Re: Show HN: GlycemicGPT – Open-source AI-powered diabetes management

#67

Post by mexicocitinluez »

AnthonBerg wrote: post #59
mexicocitinluez wrote: post #48

Earlier quoted context omitted.

> This is not an app for the general public. Can you point me to where it explicitly says that this app is not to be consumed by the general public? Or explain how that could even be enforced? And my entire point was "baseline adult competence" means very little. Competent in what? Technology? Insulin administration? Both? If they're competent in technology but not insulin administration, than this is obviously a bad…

This is as dangerous as people talking together on e.g. Facebook groups. I've seen people give flat out dangerous advice, and other people take it. Nursed someone back to health and went through a T1D pregnancy and certainly had to work with the clinicians during; Desperately: There is use for this software, and no greater need to bury it or unmake it than it is to bury or unmake Facebook groups or other discussion v…

> his is as dangerous as people talking together on e.g. Facebook groups. I've seen people give flat out dangerous advice, and other people take it.

Not even remotely close. A large portion of people in the field still don't understand how LLM's work let alone your grandmother on Facebook. They're apples and oranges.

> There is use for this software, and no greater need to bury it or unmake it than it is to bury or unmake Facebook groups or other discussion venues.

Discussion forums are nothing like an LLM. People don't assume the other person on the forum is magic. Again, these are totally different things that have no correlation with each other. People have been in some form of forum for hundreds of thousands of years. They have no experienced a genie that has ingested the entirety of human knowledge. They're just flat out 2 different things.

And you're experience as a single person doesn't mean that experience is universal. I quite literally work with clinicians and patients every day. Clinicians aren't evne sure how to use these tools (with actual clinical knowledge), but yet we're ready to shoot them out to consumers? It's wild.

Of course there is a need to get better info, but that doesn't then follow that the route of that should be an unregulated, unlicensed LLM.

Re: Show HN: GlycemicGPT – Open-source AI-powered diabetes management

#68

Post by pimeys »

tornadofart wrote: post #66
pimeys wrote: post #52

Earlier quoted context omitted.

I don't know, Dexcom G7 is accurate enough. I do random tests from finger and it's about there a bit off but close. The previous versions were wildly off if you're having a hyperglycemia, and also G7 doesn't peak as high as measured from a finger. But in that level you already have ketones in your blood, and insulin resistance, and a bit extra insulin from the pump will not drop you to hypo.

Dexcom G7 has had inaccuracies for me. A standardized product meets non-standardized living beings, I guess.

Yeah. That's why my doctor lets her patients to test with different CGMs. They work differently with different people. For me Dexcom has always been best, but my doctor uses Libre because that suits her better.
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