[ Nutrition ]

Do It Yourself Diabetes

Rather than giving yourself individual injections of insulin every time you need it, an insulin pump provides you with rapid or short acting insulin continuously, on a 24 hour basis. Now small-cap Tandem Diabetes Care ($TNDM) has nabbed the next nod from the agency for an insulin pump with an integrated CGM, the t:slim G4 Insulin Pump. This fact, in and of itself, I am fine with. It represents about 10% of the total diabetes population and involves immune-mediated destruction of insulin producing cells in the pancreas. Advances in technology have helped those with diabetes stay on top of their glucose levels. Med-T released the system in only seven cities, and it had to be prescribed by an endocrinologist. Click Select a Device (bottom), or the arrow (bottom) next to the name of your previously selected diabetes device.

It comes with the longest-wear sensor on the market and features customizable alerts and a built-in low glucose alarm (55 mg/dL alarm) to warn patients of pending highs and lows so they can avoid potentially dangerous situations. Dana: Originally no, but more recently we’ve built a full closed loop version of #DIYPS, that is essentially an artificial pancreas, that talks to my pump and adjusts to give me a little more or a little less insulin. I didn’t hear her voice as a person or an empathetic caregiver come through. Current monitoring of diabetes in pregnancy consists of intermittent self-monitoring of blood glucose (SMBG), which yields capillary glucose measurements. For every 10 years since diabetes diagnosis, the odds ratio of being a Routine Reviewer was 1.7 (95% confidence interval, 1.2, 2.4 [P=0.01]). Especially in the era of heightened security, traveling with an insulin pump can seem frustrating and time consuming. Ltd, and Terumo CORPORATION (TSE: 4543).

The devices also have indicator arrows, which will tell a person whether they’re heading into the hypoglycemia range and need to take action, like taking carbohydrates, and also show high glucoses. Over the past year I’ve produced more than 130,000 data points of blood sugar levels alone. That gives me an incredible picture of what’s happening. When used along with a blood glucose meter to obtain a more accurate reading of actual blood glucose levels, the Dexcom G4 PLATINUM CGM can also help people with diabetes make long-term adjustments to their treatment plan to keep blood glucose levels in a safe range. Yikes! Dana: We first started building the system just to make the alarms on the device louder, to wake me up because I would sleep through them. The device manufacturers didn’t seem to have a solution.

Then we started looking at getting the data onto a computer so Scott would be able to view it. At the time, we had recently started dating, and he lives 20 miles away. I wanted him to be able to see what my blood glucose level was, so if it was low, he could text me; and if I didn’t respond, he could call 911. Or the size of a grain of rice. Scott: The key moment was when we saw a tweet from John Costik, who was working on the Nightscout Project. It is not enough to merely create a device that works, our ultimate goal should be to improve the entire experience for the patient, as much as possible. I tweeted John right away: “Hey it would be awesome if we could get access to this code.” That’s really where it started.

And along the way the whole process has been extremely public. Safety Alarms To help you catch high or low glucose even if you’re not staring at your screen, your CGM will sound an alarm. Dana: #WeAreNotWaiting is a hashtag that was coined at a conference hosted by an online diabetes advocacy and information sharing community called DiabetesMine.com. What about the fact that it allows her to “see how my day went overnight” as far as blood sugar numbers? In three to ten years there’ll be devices like our artificial pancreas systems out in the market, being sold by companies approved by the FDA. I need to be alive when that system gets out in the market in, perhaps, five years. Scott: Right about the time that we started working on #DIYPS, the Nightscout Project started to grow really quickly.

There are now over 10,000 people in the CGM in the Cloud group. Over 2,000 people are using Nightscout to view their own or their loved ones’ blood sugar levels remotely on phones, watches, and other devices. For more information about Healthline’s partnership with Diabetes Mine, please click here. And that’s only going to accelerate as more people do more interesting things like this closed loop that we’ve just done. Dana: People often don’t understand why its legal for us to ‘hack’ a CGM and an insulin pump. (Note that hacking isn’t a negative thing; we’re just sharing the data across devices!) They assume that because all my DIY gadgets are not FDA-approved to use them the way I’m using them is somehow against the rules. Samantha Katz is the digital health lead and a senior strategist at Continuum, a global innovation design consultancy.

And if I share my data, that’s obviously a kind of speech. But if we decide to share our code? I think the FDA sees this as a gray area. We very much want to continue our conversations with regulators. Dana: I feel that every time I answer this question my answer changes, because my understanding of its potential is constantly changing. Our grips allow users to enjoy pool, lake and beach time without the fear of their devices falling off. Right now one of our goals is to make sure that the knowledge we gained about diabetes through our work with #DIYPS is adopted by clinicians, and that patients have access to this new information for treating diabetes.

We’re also taking #DIYPS to a new level with #OpenAPS, an open and transparent effort to make safe and effective basic Artificial Pancreas System (APS) technology widely available to more quickly improve and save as many lives as possible and reduce the burden of Type 1 diabetes. Scott: A few of months ago, at a conference convened by the advocacy group DiabetesMine, we got up and talked about our project, and I said: “I’m putting a stake in the ground that we’re going to make a closed loop artificial pancreas by August 1st, which is the date we’re getting married.” Everybody applauded and thought that was awesome. Then we went home. And we had it done in two weeks. Dana: For anybody who wants to get involved in this, we would love to talk to you. There are so many people with diabetes and there is so much data that drives the management of this disease.

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