[HN Gopher] Open-source automated insulin delivery system given ...
___________________________________________________________________
Open-source automated insulin delivery system given approval by
team of experts
Author : geox
Score : 132 points
Date : 2021-11-14 12:09 UTC (10 hours ago)
(HTM) web link (www.kcl.ac.uk)
(TXT) w3m dump (www.kcl.ac.uk)
| dpezet wrote:
| The headline is a little misleading. "Approval" is not really
| possible as these are unregulated devices. This is just a group
| of experts providing guidance on their use.
| WhisperingShiba wrote:
| Its not at all misleading, you just have a strict view of what
| it means to give approval.
| barbs wrote:
| Related: "Diabetics Are Hacking Their Own Insulin Pumps"
|
| https://youtu.be/bouYRMItWnI
| ody4242 wrote:
| Their repo has like 300 open issues today... I have type 1
| diabetes, and use open source tech for getting the glucose
| readings from my sensor and pushing it to a Pebble, but insulin
| dosing is a way more complex story.
| serf wrote:
| >Their repo has like 300 open issues today...
|
| that's a metric to compare only because that data is available.
|
| how many issues are open on the tracker for the closed-source
| equivalent?
| ody4242 wrote:
| I have no idea, that's why I am not using an insulin pump
| either:)
| sithlord wrote:
| where is the repo at?
| KMnO4 wrote:
| https://github.com/LoopKit/Loop
| ksaun wrote:
| Would you please share which sensor and which open source tech
| you use?
| ody4242 wrote:
| I use Dexcom G6 CGMS with Nightscout and xDrip+. xDrip+ runs
| on Android, gets the data from the Dexcom transmitter, and
| sends it to a Pebble watch and also to a mongodb database.
| xDrip itself supports a lot of CGMS systems, I've been using
| it since G4, which was not Bluetooth ready initially, so you
| had to build a bridge that read the data from the transmitter
| and sent it to the phone. Way easier nowadays,as the
| transmitter is using BLE.
| spanktheuser wrote:
| An interesting question to ask one's self: how many open issues
| exist in the private repo of the various commercial insulin
| dosing providers? How would one judge, at any given moment,
| whether Company A or Company B has the more robust software?
| And whether Company C's recent v2.0 release has increased or
| decreased the reliability of their software?
| pimeys wrote:
| I've been using another similar system called AndroidAPS for
| three years now. With Dexcom G6 and DanaRS pump it means I never
| need to measure my glucose from my fingertips, be afraid of hypos
| and wake up every morning with a 5.5 mmol/l glucose. My A1c has
| been 6.0% the whole time and all I need is a bluetooth capable
| Android phone.
|
| A night and day difference to the hell I was living with my T1
| before I found this system...
| hirundo wrote:
| I imagine reviewing a pull request for a repo like this and
| shudder in horror. I've never understood a significant piece of
| software in my life to the degree that I'd be confident having it
| control the contents of someone's bloodstream. I know many
| programmer's don't have the luxury of having only bugs that can't
| kill people. I'm just glad I'm not one of them. With the best of
| my intentions and skills, every app I've written has ultimately
| been a house of cards, supportable only by extensive testing,
| that can and does fall over at a stern thought. I'd like to write
| truly robust software but it doesn't look like one of my
| practical options at the moment.
| twobitshifter wrote:
| Standards must be followed and testing can add a great deal of
| safety. And for an individual contributor, there could be
| potential liability if standards weren't followed. Even so, I
| think in terms of social value per line of code, you'd feel
| much better spending your time on a project like this.
|
| We should understand that the alternative is very imprecise:
| poking yourself and trying to time the right delivery of
| insulin doses, based on your current blood sugar, exercise
| levels, meals, etc. It's a guessing game with diabetics, so
| this is a giant leap forward in making them healthier, even if
| the tech wasn't 100% perfect.
|
| My dad had been lethargic as he ages, the doctors just told him
| that the level he was maintaining his blood sugar at was much
| lower than he should be at for his age. They also gave him an
| in-arm blood sugar reader. The difference from these small
| changes has been enormous. He seems more alert and healthier
| than he has in the last couple of years and he keeps more on
| top of the sugar levels with the new reader. My point here is
| that people risk their own lives trying to manage their own
| blood sugar, and even the smallest tech add, like a device that
| suggests the right insulin dose can be life altering. Diabetics
| who fail to manage their blood sugar properly can lose limbs
| and go blind. Given the choice of going it alone or using a
| technology used by many others, I know what I'd choose.
| the_d3f4ult wrote:
| Don't forget that if you miss an edge case lawyers will take
| your house and your life savings. Welcome to medicine = )
| walterbell wrote:
| If my life depended on a piece of software, I would choose the
| programmer who understood the impossibility of their task.
| tsol wrote:
| I think one of the considerations with open source medical
| software like this is price-- for many who can't afford
| anything better its a suitable risk, perhaps with excess
| monitoring by the user. The ideal situation is for everyone to
| have easy access to the best equipment, but in some countries
| that just isn't possible. Not to 'shoo' away your concerns, I
| do think the still need to be accounted for, but I don't think
| they represent a roadblock for such an initiative
| go_elmo wrote:
| Theres also the possibility to verify things, which is at least
| as much effort as to write it in the first place but then you
| know it wont kill anyone.
| alexmcc81 wrote:
| There are standards they likely have to follow, e.g. IEC 62304.
| krisrm wrote:
| It doesn't look like hackers are necessarily the intended
| audience, but it would have been interesting to read about some
| of the failsafes preventing this system from causing overdoses or
| other dangerous conditions.
| lostdog wrote:
| The reference design document was both an interesting read, and
| gave a lot of detail on how the system aims to be as safe as
| possible: https://openaps.org/reference-design/
| lolc wrote:
| One of the failsafes is the conservative amounts of insulin the
| software is allowed to dose on its own. In my case, it is set
| to never deliver more than 1.2 units of insulin per hour. If it
| wants to deliver that amount, it will instruct the pump to
| raise the continous supply of insulin for half an hour. In
| contrast, I will routinely instruct the pump to deliver 8 units
| at once for a meal.
|
| So if say the blood glucose sensor delivers faulty measurements
| (that happens frequently in my case) it may gradually try to
| kill me, but it takes hours to get me into a dangerous zone.
| This is a lot of time for me to notice and correct. I mainly
| like the system for correcting while I sleep. I wake up less to
| a low sugar thanks to the software suspending insulin delivery,
| and high sugar at night is often corrected by the time I wake
| up.
|
| I don't know about failsafes on the lower levels. I kind of
| trust it after a year on OpenAps :-)
| Guidii wrote:
| Glad to see more folks supporting efforts like this. I've been
| using a similar DIY approach[1] to manage my diabetes for four+
| years, and it's been surprisingly effective and impactful.
|
| Happy to take any questions about how closed loop works,
| technologies+processes, comparison to other therapies, etc.
|
| Background: SW Dev + Type 1 diabetic for 47 years;
|
| [1] https://openaps.org/
| dwt204 wrote:
| As an adult, I use a GCM manufactured by Abbott, which allows for
| scanning and recording data, charts etc. I inject appropriate
| insulin dosage after reading the GCM scan. The software and
| hardware are proprietary for use with IOS. The package is very
| effective and accurate, and very expensive if you consider how
| much insulin, needles and the consumable GCM cost together. It
| works and I have been able to get very good, tight control using
| their system. Until OS software and hardware catch-up, this might
| be a good intermediate step for those who can afford it. Pumps
| are always going to be problematic until they are simple enough
| for youth to understand and maintain them, since most Type 1s
| start out at a young age being insulin dependant.
| dtgriscom wrote:
| > very expensive if you consider...
|
| Do you mean "very inexpensive"?
| brianzelip wrote:
| (Off topic but related to insulin hacking)
|
| We (University of Maryland, Baltimore library) are hosting a Zoom
| talk by the Open Insulin Foundation next week, November 17, 12pm
| EST/UTC-5.
|
| RSVP and details:
| https://umaryland.az1.qualtrics.com/jfe/form/SV_cHzZ72AJcosM...
| jimrandomh wrote:
| I use, and have contributed code to, one of these
| (OpenAPS/oref0). There's actually a pretty shocking amount of
| spaghetti code, shell scripts, and cobbled together components in
| different languages. The key thing that makes it work is that,
| safety-wise, it fails more gracefully than you might think; if it
| stops working it falls back to what would be the no-automation
| standard of care anyways, and there are high- and low-glucose
| audible alarms from the CGM going through an entirely separate
| path that has no DIY in it.
___________________________________________________________________
(page generated 2021-11-14 23:00 UTC)