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Comment by pimeys | Hacker News Reader

I'm like you when I do any activity having insulin on board. I'm a T1 using a pump, and I really like the combination of a pump and CGM for staying away from surprises. I use AndroidAPS to monitor my glucose and insulin on board, taking a temporary basal setting of 0% if needed before any activity, so my insulin on board drops to the base level or a bit below.

Soon the insurance replaces my pump to a Dana RS, which supports closed looping with AndroidAPS. Then it's just setting a temporary glucose target to a higher value and the system takes care of the basal rates to keep the glucose from dropping.

The article here is kind of weird. How am I supposed to dose e.g. 0.3 units or 0.75 units of insulin with the pills? The ability for a very fine granularity and the possibility to automate my medication are much more interesting compared to the pills mentioned in the article.

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You are spot on.

The temporary reduction or even suspension of insulin depending on my activity are key in preventing lows for me.

The closed loop pumps are the biggest improvement I've seen for living with T1. There's always lots of promises, but this is one of the few things that really improves my life on a day to day basis and it just keeps getting better.

Right now it seems there is official support only to prevent hypos, but not to give you more insulin at night when you ate something too heavy and didn't guess the right TBR.

Only the open source AndroidAPS for Android and Loop for iOS do this. And then you have a very limited set of pumps you can use.

The Medtronic 670g is the only pump that currently will automatically correct highs, but it only works with the Medtronic CGM which is untrustworthy.

The Tandem t slim x2 only has support for hypo prevention today, but it supports at home firmware/software updates and they are pretty far along with the FDA on getting approvals for their auto dosing for highs. They anticipate a release this summer.

I wish that OmniPod was further along on this front. I would love to have a tubeless solution and the convenience of not needing to disconnect every time I'm going to get in the water, but the trade-off just isn't worth it IMHO.

If you can to get the right pump, I highly recommend compiling one of these apps. Just wipes out all the competition from the commercial axis, truly life changing apps if you learn how to use them.

https://github.com/MilosKozak/AndroidAPS/

https://github.com/LoopKit/Loop

These open source projects, written by people who actually have Type 1 are light years ahead of doing what I want a closed loop system to actually do. The medtronic 670 is so unusable. I can't say enough good things about OpenAPS AAPS (android) and Loop(iphone). For those living in the US, we are forced to use a very old medtronic pump because it's the only way with a programatic means to control the pump's basal and bolus actions.

OmniPod support is coming to AndroidAPS. Development has already started.

https://androidaps.readthedocs.io/en/latest/EN/Getting-Start...

Yeah, I noticed that. I went and took a look to see how the project was coming along after you reminded me of it.

I would be seriously interested in a closed loop Omnipod, but it will be awhile before I’m eligible for a new pump under insurance.

I was kind of "lucky" Animas went bankrupt and they will take all the pumps back paying money for the insurance, so I get a new Dana RS earlier in a couple of months.

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