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A $250 Biohack That’s Revolutionizing Life with Diabetes

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Re: A $250 Biohack That’s Revolutionizing Life with Diabetes

#141

Post by pimeys »

arendtio wrote: post #59

So some people are concerned that their cars have an internet connection and others connect their bodies to it (via the smartphone) and at the same time, both have good reasons to do so :-D Sometimes it is a strange world we are living in. While I admire open source and DIY solutions in general, they often lack the quality assurance a company specialized in medical equippment is used to. So I hope that soon there wil…

You have to understand that for people like me, who didn't sleep many good night sleeps for almost a decade, this is the only available solution right now to fix the issue. I prefer taking the risk and sleep without worry any day.

You definitely need to know what you're doing though. But AndroidAPS saved my life.

Re: A $250 Biohack That’s Revolutionizing Life with Diabetes

#142

Post by Gregoriy »

DavideNL wrote: post #98
Gregoriy wrote: post #47

Earlier quoted context omitted.

I am involved in this, what i want to say is that openaps are not the best option anymore, and pumps of metronic are not required anymore, android app & other pumps what we use right now.

With the poor state of Android security at the moment (in a nutshell, Android 9 Pie was just released while the previous Oreo release is installed on only 12% of devices), i cannot imagine anyone would want to connect a device that "can easily kill you" to an Android phone. Most non-technical people using this DIY solution are probably not even aware of this...

The way it works make in sort that it can't kill you easy at all, the system does not regulate bolus insulin which is without a limit, but a basal rate which is basically a rate of insulin distribution from slow to fast, even the fastest mode will not kill you, and if the system disconects for some reason pump uses a default average speed.

Re: A $250 Biohack That’s Revolutionizing Life with Diabetes

#143

Post by pimeys »

exDM69 wrote: post #112
acqq wrote: post #110

Earlier quoted context omitted.

Old way: you repeat the measurement nothing is in your body. and you konw di you feel e.g. hypo. New way: the sensor needle is simply a little off (in stays sticked). You don’t know, the software doesn’t know. The sensor is not magic that works 100% of the time, it ends in a needle sticked in your body, many ways to go wrong, even if it worked a while. And the danger of “fully automatic” is there.

Just to clarify, we were only discussing monitoring and sensors in this subthread. Not closed loop pump systems. A sensor failure in closed loop is dangerous. I do not know how the control software detects and deals with this. I have no experience with them.

A closed loop uses the oref0 algorithm, which tweaks your basal levels and therefore cannot react to fast peaks or cause a hypo not easily fixed by having two candies (or giving an alarm if you're not awake). What it does is it detects an upward trend for the last X measurements, sets something such as 300% temporary basal rate, detects the trend reaching the peak, sets a 0% basal rate until you hit the predefined target (for me, 5.5 mmol/l during the day and 6.5 mmol/l at night). Here sudden wrong readings will not cause any harm or danger.

The new oref1 algorithm uses a method called super micro boluses, which can detect a sudden peak or unannounced meal, sees the first jump up, gives you a bolus so it borrows from the basals, setting the basals to 0%. The algorithm works really well for things such as eating a pizza, where you get about 50% of the carbs immediately and the rest + a bit more during the next five hours. So you take a bolus for the food, then when the fat hits in the oref1 will give you tiny boluses.

The latter is more sensitive to sensor failures, so it is on only when you told the system you have some carbs in your body, or if you happen to have a Dexcom G5 or G6 sensor with good noise readings, it will be on all the time and the system knows when the reading is faulty.

Re: A $250 Biohack That’s Revolutionizing Life with Diabetes

#144

Post by pimeys »

acqq wrote: post #131
exDM69 wrote: post #112

Earlier quoted context omitted.

Just to clarify, we were only discussing monitoring and sensors in this subthread. Not closed loop pump systems. A sensor failure in closed loop is dangerous. I do not know how the control software detects and deals with this. I have no experience with them.

Thanks. Readers should also note that the main topic is about the closed loop apparent "revolution." In reality it really can be dangerous, exactly because of the explained sensor problems which are real. To clarify to those that don't know: The sensors are big things with the needle permanently in your body. You don't want three needles permanently to be sure that at least 2 from 3 work. If you have only one, you ha…

I'd say that I myself making all the judgements caused way more harm to my body than what the computer can do. It is that much better. Before I used to have nights when my sugar was in a dangerous hypo for hours during the night, luckily not causing too much brain damage. Now all of these problems are gone. Almost all of the scary hypos are gone. My A1c came down from 7.5% to 5.5%. I'm 88% of the time in range, 10% above the 8.5 mmol/l and 2% hypos (none of them at night) which I can correct fast due to alarms.

Re: A $250 Biohack That’s Revolutionizing Life with Diabetes

#145

Post by pimeys »

jkeller_86 wrote: post #84
jimrandomh wrote: post #16

The article, strangely, leaves out the name of the project it's reporting on. It's OpenAPS, http://openaps.readthedocs.io/en/latest/ . I use it and have worked on the code. It's a massive health and quality of life improvement over anything that exists which is FDA approved. The core problem is that the FDA-approved devices are optimized not for getting the best result, but for ensuring the manufacturer can't be blam…

They actually aren't leaving out the name of the project, it's called Loop - the system that she's on is not actually OpenAPS. I've tried both systems, OpenAPS lacks a clean, user friendly UI. As a result, most people (according to a recent survey) are running Loop instead of OpenAPS.

And if you have different hardware (Combo, DanaR/RS), AndroidAPS gives a clean and nice UI and is based on the OpenAPS algorithms.

Re: A $250 Biohack That’s Revolutionizing Life with Diabetes

#146

Post by DavideNL »

Gregoriy wrote: post #142
DavideNL wrote: post #98

Earlier quoted context omitted.

With the poor state of Android security at the moment (in a nutshell, Android 9 Pie was just released while the previous Oreo release is installed on only 12% of devices), i cannot imagine anyone would want to connect a device that "can easily kill you" to an Android phone. Most non-technical people using this DIY solution are probably not even aware of this...

The way it works make in sort that it can't kill you easy at all, the system does not regulate bolus insulin which is without a limit, but a basal rate which is basically a rate of insulin distribution from slow to fast, even the fastest mode will not kill you, and if the system disconects for some reason pump uses a default average speed.

> the system does not regulate bolus insulin which is without a limit

I understand that but the issue remains;

all a hacker would have to do is set basal rate to 100000% and then you have a "bolus that kills you".

Call it basal or bolus, it doesn't matter. The pump just pushes out insulin, and the amount can be controlled if you can hack the system.

Re: A $250 Biohack That’s Revolutionizing Life with Diabetes

#147

Post by slantaclaus »

zaroth wrote: post #18

A continuous glucose monitor (CGM) uses a very thin gauge wire to sense interstitial fluid as a proxy for blood sugar. My kids have tried Dexcom G4 CGMs a couple years ago. The G4 was never approved to dose insulin directly off the CGM reported value, we would confirm with a finger prick before dosing a correction. The G4 also required “calibration” where you would type in the reading from a finger stick and it would…

I use a tandem pump and a Dexcom G5 (g6 sensors in the mail though). The update for the real closed loop system is supposed to be released in about a month or two. Cannot wait! Was dubious about the g6’s purported accuracy. Your report gives me confidence though

Re: A $250 Biohack That’s Revolutionizing Life with Diabetes

#148

Post by sdmike1 »

femto wrote: post #136
sdmike1 wrote: post #93

Earlier quoted context omitted.

As a "reverse engineering hacker" who is a diabetic with one of these pumps (The 670G to be specific) I have black boxed the shit out of it, but because it is doing a good job of keeping me alive and the cost of a new one is high I have yet to disassemble it and do a thorough RE of it. In ~4 years when the warranty is up an insurance is willing to replace it then I will be disassembling it and hacking the shit out of…

What happens to all the pumps that break? Chances are that the mechanics break before the electrics, so there will be a bunch of broken pumps with intact electronics somewhere in the wild. Can they be had as freebies for reverse engineering? Many would get returned to Medtronic under warranty, but there would be exceptions?

I had one mechanically fail this summer and my options were turn it in or pay $3,600 and as much as I want to RE it I don't want to spend $3,600 on it. So far medtronic is doing a very good job of limiting the secondhand market on these. I do make regular ebay crawls looking for them through. so far nothing has really turned up :(

Re: A $250 Biohack That’s Revolutionizing Life with Diabetes

#149

Post by shriver »

davidgrenier wrote: post #71
dekhn wrote: post #70

Earlier quoted context omitted.

Hi- I used to work in regulated pharma and I want to be clear: " The core problem is that the FDA-approved devices are optimized not for getting the best result, but for ensuring the manufacturer can't be blamed if something goes wrong" is a misleading statement. The reason everything is regulated is that sometimes things do go wrong, and it's necessary to have root cause attribution so the problem can be remedied an…

Somehow I can't help but read you've smuggled endorsement for: It's ok if the product is more dangerous when bundled with the benefit that we can blame it on some organization.

That's not the endorsement. The endorsement is that it's okay for a single product to be suboptimal as long as the system is optimal. It's more optimal to prevent or slow down a number of innovations in order to protect the vast majority of people from the sort of mistakes and scams that other industries accept as standard.

Re: A $250 Biohack That’s Revolutionizing Life with Diabetes

#150

Post by jimrandomh »

dekhn wrote: post #132
jimrandomh wrote: post #122

Earlier quoted context omitted.

Deep understanding of the system, plus personal experience. There is a repository of OpenAPS users' logs, accessible to a small pool of researchers, but (for medical privacy reasons) there isn't any central fleet monitoring. Each user has detailed logs of what their own install saw and did and why, and is expected to monitor it closely. (And we do in fact monitor them--not just as a precaution, but as a necessary par…

When you say The worst-case scenario is quite well understood: excess insulin, up to a configured dosage limit. Is the configuration software controlled? IE, if you had a bug in your configuration or in your microcontroller, could that bug lead to exceeding the configured dosage limit? Or is there a hard limiter (fixed amount of insulin, a physical limit switch, etc) that prevents that.

There's a software limit, selected by the user, in the microcontroller. There's a per-bolus limit, selected by the user, in the pump. There's a physical limit, in the amount of insulin that is loaded into the pump at a time (typically 2-5 days worth).
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