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Comment by templaedhel | Hacker News Reader

If you have an insulin pump (best if it's an older one, since newer ones are harder to hack) you should look into OpenAPS (open artificial pancreas system) https://openaps.org/. People have code/schematics available to build a closed loop system between CGM<>insulin pump which automatically adjusts the dosage based on glucose levels and keeps you in range better than even the best attempts at manual dosages. Seems like you've already done half the work, which is connecting the CGM to a device you can run custom code on.

Medtronic just came out with their first closed loop system (https://www.medtronicdiabetes.com/products/minimed-670g-insu...), but OpenAPS has been around for years, and not sure how Medtronic will go about getting the 670 approved in Germany.

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The Medtronic 670g was my other option, but I took the Animas Vibe + Dexcom G4 just because it's easier to hack, lots of German Diabetes hackers use it, its CGM seems to be more accurate and you can use the G4 sensors way longer than the 670g.

670g is a closed loop system, but what it does is it stops giving you the basal insulin when it thinks you are getting a hypoglycemia soon. What it doesn't do is to give you correct amount of insulin automatically when you've been eating carbs or doing exercise to keep your glucose level in the 5.5 mmol/l target. And with the new Fiasp insulin automatic adjustments would be possible.

To be able to build the OpenAPS, you must have an older Medtronic pump which are not covered by German insurance anymore. My Animas doesn't allow to tweak the insulins remotely.

The 670G completely controls basal rates; the "suspend on low" functionality arrived in a previous generation. But it won't keep your blood glucose at 5.5 mM -- it targets 6.7 mM, and there doesn't seem to be any way to change this. :-/

Sounds nice. I still think I'm going to manage my insulins manually until the next generation of artificial pancreas. This system what I have is already the biggest ever improvement for my diabetes I've ever had.

Isn't it a bit scary to run the auto-insulin code on an android phone?

I do not have an insulin pump and I'm presuming you don't with my response. The pumps I have seen make noise when they are pumping and also have an alarm (I'm not sure if that's from the pump or the reader) if your levels are on either extreme. I'm guessing malfunctioning code would only execute once by pumping too much or not pumping at all and the user would figure it out very quickly.

I'd argue the users can't identify anything if they are rendered unconscious:

https://en.wikipedia.org/wiki/Diabetic_coma

You definitely don't want anything buggy with medical devices.

I agree about the importance of medical devices but I don't think diabetic coma happens as easily as you think for most (if they are on one of those full-systems). From what I've seen from insulin pumps/systems:

1. There is a max rate that it can pump

2. There are alarms that go off if the numbers are above or below your settings (I believe there are also max and mins for those so you can't accidentally set it to a 'fatal' number)

3. The systems seemed 'independent.' The reader did not take for granted that the pump was pumping, but rather continually monitored glucose levels and would still set off an alarm if the numbers weren't within the bounds.

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