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On Building My Own Artificial Pancreas

liamz.co

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Re: On Building My Own Artificial Pancreas

#31

Post by refurb »

noir_lord wrote: post #2

It's a damn shame that years after this became a thing we are still waiting for a proper commercial product to hit the market at a reasonable price , I had a male relative with T1 diabetes and it was a complete burden on his life, We have the technology to improve peoples lives markedly (because we already did) but because of what the author mentioned in the article and the lack of "skin in the game" manufacturers ar…

Spoken like someone with little knowledge of what it takes to get a medical device approved by the FDA.

As an FYI, you can’t “move fast and break things” when it comes to medical devices.

Re: On Building My Own Artificial Pancreas

#32

Post by [deleted] »

devoply wrote: post #30
jacquesm wrote: post #8

So, for those of you that feel that this is worthy of hacking: Diabetes is one of those diseases that seems right where your average hacker would like it to be. A single value (Blood Glucose Level) which you can read using some sensor and an automated delivery method. Connect A to B using some 30 lines of Python and call it a day. But it is not that simple. The manufacturers of these devices have to go through some p…

meh still it seems extremely trivial for pretty much any well funded startup to do... and extremely surprising that it does not exist. i mean if theranos can exist, why the hell is this problem not solved?

[deleted]

Re: On Building My Own Artificial Pancreas

#33

Post by dreamcompiler »

abtinf wrote: post #22
jacquesm wrote: post #8

So, for those of you that feel that this is worthy of hacking: Diabetes is one of those diseases that seems right where your average hacker would like it to be. A single value (Blood Glucose Level) which you can read using some sensor and an automated delivery method. Connect A to B using some 30 lines of Python and call it a day. But it is not that simple. The manufacturers of these devices have to go through some p…

Note that glucose is only a proxy for the actual thing we want to control, which is insulin.

Um...no. Excess glucose kills you slowly with tissue damage and ketoacidosis. Too little glucose kills you quickly by starving your brain of something it needs. So glucose is very much the stuff we want to control. The mechanism for regulating glucose is insulin.

Re: On Building My Own Artificial Pancreas

#34

Post by myrryr »

devoply wrote: post #30
jacquesm wrote: post #8

So, for those of you that feel that this is worthy of hacking: Diabetes is one of those diseases that seems right where your average hacker would like it to be. A single value (Blood Glucose Level) which you can read using some sensor and an automated delivery method. Connect A to B using some 30 lines of Python and call it a day. But it is not that simple. The manufacturers of these devices have to go through some p…

meh still it seems extremely trivial for pretty much any well funded startup to do... and extremely surprising that it does not exist. i mean if theranos can exist, why the hell is this problem not solved?

It is, closed loop system are about to be legal in New Zealand, and the pumps the govt supplies will support it.

It has just taken time.

Re: On Building My Own Artificial Pancreas

#35

Post by jacquesm »

AdamJacobMuller wrote: post #20
jacquesm wrote: post #15

Earlier quoted context omitted.

> Any comments? I hope they don't mess up the encryption on the pump commands. Especially with pumps that can deliver high doses that can be really problematic.

Is it possible to have interlocks whereby a pump will refuse to dose more than X ml over Y hours or is a fatal dose for some people in some scenarios less than a therapeutic does for others in other scenarios?

Body weight is a huge factor, so what is fine for an adult can kill a child. There are a lot of factors at work here that influence this so there is no easy answer as to what is a 'safe dose'.

Re: On Building My Own Artificial Pancreas

#36

Post by jacquesm »

devoply wrote: post #30
jacquesm wrote: post #8

So, for those of you that feel that this is worthy of hacking: Diabetes is one of those diseases that seems right where your average hacker would like it to be. A single value (Blood Glucose Level) which you can read using some sensor and an automated delivery method. Connect A to B using some 30 lines of Python and call it a day. But it is not that simple. The manufacturers of these devices have to go through some p…

meh still it seems extremely trivial for pretty much any well funded startup to do... and extremely surprising that it does not exist. i mean if theranos can exist, why the hell is this problem not solved?

Well funded start-ups (and established players) are all working on this. Given that the market is huge and Diabetes is yours for life you can bet that a lot of clever people have spent a lot of time on this. Not all of the companies that work on this problem have made it, on top of that it is a patent minefield. It will take you a few 10's of millions of $ or Euros to get to market and you would need to do everything right the first time. Then you still don't know much about how your device will function in the field until enough time has passed that you can judge by the returns where you got it wrong. Doing a respin is expensive.

So, Theranos can exist, and if the money that had gone to Holmes and then this indeed would be a solved problem. But it didn't. Note that there are pumps with a closed loop option on the market today, but they are neither convenient nor simple to use. It is work in progress. I fully expect a simple to use closed loop system to be available in quantity somewhere in the next year or two based on recent market research. The time is indeed ripe. The basic tech is there and the pumps have achieved a level of miniaturization and reliability that it is feasible, there are still problems to overcome but those are all within the realm of the possible, do not require unobtanium and enough parties are working on it (competition is fierce) that at least one of them will solve it within that time frame.

Re: On Building My Own Artificial Pancreas

#37

Post by TrackerFF »

noir_lord wrote: post #2

It's a damn shame that years after this became a thing we are still waiting for a proper commercial product to hit the market at a reasonable price , I had a male relative with T1 diabetes and it was a complete burden on his life, We have the technology to improve peoples lives markedly (because we already did) but because of what the author mentioned in the article and the lack of "skin in the game" manufacturers ar…

One would think that insurance companies would jump through flaming hoops to get their diabetes clients the best possible treatment. It is such an expensive condition (I would guess the most expensive), which just gets worse with time.

My sister has T1, and it's a sh!tty disease. She's young, lives a very healthy lifestyle, but still these complications keep creeping up.

I (and my sister) are very lucky to live in a country with socialized healthcare, so there's no financial burden on her - but I can only imagine how expensive it would be for those without that option - worst case the uninsured; more so in the long run.

Re: On Building My Own Artificial Pancreas

#38

Post by sgift »

jacquesm wrote: post #14
liamzebedee wrote: post #13

Earlier quoted context omitted.

A bit of elaboration on the risks you could encounter here: - CGM sensors can be faulty, depending on the rate of change of glucose (they’re actually not measuring blood directly, but interstitial fluids, which are generally lagging by about 15mins and can be inaccurate with large swings) - battery dying out isn’t so bad, since the pump will just default back to its previous basal delivery settings - there are safety…

And then there are... pump actuator failure, syringe seal failure (on syringe based pumps), valve failure (on valve based pumps), user error (on all systems), reservoir running out, occlusion, air bubbles and a thousand other things that can go wrong. This is not exactly easy material in the best of cases and most sensor packages do not have redundancy and will at best address only a small fraction of all possible fa…

Delivering something fast, accurate and under wildly changing conditions in the human body is far more complicated than most people assume.

I still remember when I had to be hooked up to an infusion pump for many hours at a time. In theory this was all pretty simple - I had a port (a permanent link to my blood system), the machine was hooked to the port, the machine was configured to deliver x ml per hour. Easy, right? Well ... moving my arm had a non-zero chance to trigger the alarm (alarm means "the machine has a problem to deliver the configured amount", please do something), moving in the bed had a higher chance, walking over the hospital corridor I could almost guarantee that at some point in a single walk (i.e. one length of the corridor) it would freak out and again start the alarm. And that's for a far easier system in very easy conditions. An insulin pump has to change what it delivers all the time and it has to work always. Sport, work, driving, running, ...

Re: On Building My Own Artificial Pancreas

#39

Post by vineyardmike »

amelius wrote: post #5
dekhn wrote: post #4

Earlier quoted context omitted.

Making a hardware product that is validated in a regulated market is non trivial. At least part of the cost goes to reducing overall risk to a large market, which open source projects aren't really resourced to address.

Isn't it possible to design the product such that its risks are greatly reduced? E.g. by limiting the amount of insulin it can deliver in a given timeframe?

Adding to what others said, too little insulin can be dangerous, so if users don't know/notice that it stopped delivering more insulin, they might not manually add the requisite amounts.

Forgetting to take medication is dangerous, overdosing medication is dangerous. It is just not that easy to design a system like this.

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