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On Building My Own Artificial Pancreas

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Re: On Building My Own Artificial Pancreas

#41

Post by bayesian_horse »

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…

That's not the point.

There are three things to an "artificial pancreas": glucose sensor,insulin pump, and the control logic. The difference between an artificial pancreas and the "manual" operation is just that the control logic is automated.

You even can't "fuck up" very easily, unless you add other diabetic stupidities on top of a malfunctioning control logic. Two failure conditions: a) Too little (or no) insulin delivered. b) Too much insulin.

The second one is the more dramatic/short term. The insulin pump has a limited supply of insulin. The speed of injection is limited. There are probably additional safeguards in the pump's software around knowing you are not an elephant breaking into a candy shop. And you feel the pump acting. You can pull it out if it behaves strangely.

Too little insulin delivered may be trickier, but you still have to check the glucose levels occasionally, probably multiple times a day.

Patients already use "algorithms" for insulin delivery. But they are comparatively shitty and designed for example to deliver insulin as a bolus after a meal. Continuous administration of insulin over a pump already has a lot of benefits. A continuous monitoring already has benefits.

Re: On Building My Own Artificial Pancreas

#42

Post by bayesian_horse »

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?

Continuous glucose sensors are relatively new.

It's surprisingly tricky to measure chemical concentrations continuously without replacing the "sensor". Blood and other liquids attack and clog everything.

Without continuous glucose monitoring, you can't do artificial pancreasing.

Re: On Building My Own Artificial Pancreas

#43

Post by bayesian_horse »

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.

That's wrong.

Re: On Building My Own Artificial Pancreas

#44

Post by bayesian_horse »

refurb wrote: post #31
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.

They apparently do, though.

Re: On Building My Own Artificial Pancreas

#45

Post by liamzebedee »

mirimir wrote: post #29
cypherpunks01 wrote: post #28

Earlier quoted context omitted.

Read the man page! ;) https://openaps.readthedocs.io/en/latest/docs/Gear%20Up/pump...

OK, I guess. But I was looking for something in TFA.

Hey Vlad - I added some pictures of what I actually wear day-to-day at the bottom of the post. Hope this helps!

Re: On Building My Own Artificial Pancreas

#46

Post by liamzebedee »

bayesian_horse wrote: post #41
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…

That's not the point. There are three things to an "artificial pancreas": glucose sensor,insulin pump, and the control logic. The difference between an artificial pancreas and the "manual" operation is just that the control logic is automated. You even can't "fuck up" very easily, unless you add other diabetic stupidities on top of a malfunctioning control logic. Two failure conditions: a) Too little (or no) insulin…

Although I would highlight - there is additional high risk now if the sensor becomes faulty, in which case, more insulin could be delivered for incorrect levels while you sleeping, etc.

Re: On Building My Own Artificial Pancreas

#47

Post by friedegg »

dreamcompiler wrote: post #33
abtinf wrote: post #22

Earlier quoted context omitted.

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.

Excess glucose doesn't cause diabetic ketoacidosis, but rather too little insulin. You can run high blood sugar for literally years without going into DKA (although it does damage your body). It's even possible in certain, rare circumstances to enter DKA with normal blood sugar.

Re: On Building My Own Artificial Pancreas

#48

Post by dekhn »

jacquesm wrote: post #9
dekhn wrote: post #6

Earlier quoted context omitted.

This comment falls under the "why don't you just..." cluster. Even implementing a feature like that (assuming it made sense) carries risk (imagine if your limiter's sensor broke and it failed open). Designing reliable systems is incredibly hard. It requires a ton of resources (money, lawyers, engineers) And experience and long time frames with relentless effort to document everything so that when somebody does die, y…

> This comment falls under the "why don't you just..." cluster. It does, but just this once it is spot on , the best pumps on the market do just that.

yes, it's spot on, but only a tiny part of a much larger system. And even implementing that feature is devishly complicated. Hence my statement "why don't you just".

Re: On Building My Own Artificial Pancreas

#49

Post by bayesian_horse »

liamzebedee wrote: post #46
bayesian_horse wrote: post #41

Earlier quoted context omitted.

That's not the point. There are three things to an "artificial pancreas": glucose sensor,insulin pump, and the control logic. The difference between an artificial pancreas and the "manual" operation is just that the control logic is automated. You even can't "fuck up" very easily, unless you add other diabetic stupidities on top of a malfunctioning control logic. Two failure conditions: a) Too little (or no) insulin…

Although I would highlight - there is additional high risk now if the sensor becomes faulty, in which case, more insulin could be delivered for incorrect levels while you sleeping, etc.

I don't know if insulin pumps are used while sleeping. After all, there's a needle inserted in your skin.

You wake up from hypoglycemia, long before there is more trouble. And the sensor doesn't post glucose levels for example if it gets detached.

Re: On Building My Own Artificial Pancreas

#50

Post by wbrasky »

bayesian_horse wrote: post #49
liamzebedee wrote: post #46

Earlier quoted context omitted.

Although I would highlight - there is additional high risk now if the sensor becomes faulty, in which case, more insulin could be delivered for incorrect levels while you sleeping, etc.

I don't know if insulin pumps are used while sleeping. After all, there's a needle inserted in your skin. You wake up from hypoglycemia, long before there is more trouble. And the sensor doesn't post glucose levels for example if it gets detached.

Insulin pumps (and their cannula; not a "needle") are installed 24/7. They can be "suspended" and the insulin delivery hose unhooked, but they are generally there, and active, at all times. Likewise, a CGM (continuous glucose monitor) will provide, as the name says, continuous monitoring. Both use adhesives to keep them attached and generally remain so, even while sleeping.

Hypoglycemia also may not lead to "waking". After all, a diabetic coma may result from low blood glucose, depending on how quickly it crashes.

Source: my girlfriend is Type 1.

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