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Comment by danielschonfeld | Hacker News Reader

As opposed to not doing anything which is the current state of Diabetes for the most part, which too, kills you and if not outright kills you then slowly does via financial ruin.

How many episodes of hypoglycemia do you think one needs to have, in an utterly broken healthcare system in which being ordered paramedics and given sugar pills costs you $XXXX per occurance.

And if you're gonna talk to me about responsbility and healthy living please join the real world some time.

That's why people choose to take actions into their own hands. Because being a victim of a system that just doesn't care enough leads you to either take the handles or down under.

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What does this even mean? Hacking an open-loop insulin pump and making it closed-loop doesn't eliminate the need for insulin, did you misread me as saying insulin prices are A-OK and diabetics should just eat healthy?

All power to these knowledgeable, individuals, for doing something dangerous but potentially great. This is HN, full of smart people who understand the risk of failure and will monitor the crap out of their system and adjust and tinker until it's ok. The problem is people making tutorials and publicizing their work, which leads to people not as smart following their tutorial and thinking it will be alright.

There are tons of papers on closed-loop systems, and probably clinical trials are happening as I write this comment. Medicine isn't one of the industries to "disrupt" though, as much as people on here want to believe.

Smart insulin pump sounds awesome. Bring them on. If it really is a smart insulin pump. Trouble was the article author was talking about 'reading his emotions' etc. There's a red flag for bullshit. AFAIK no publicly disclosed technology can, in general, read emotions. Also, why whatever signal they are using as 'emotions' is a perfect predictor of insulin levels, I don't know.

I studied control engineering, and I bet he forgot some things. A few things come to mind. How does he recognize sensor failure (pretty important in closed-loop systems, like MCAS for example)? Did he use floating point math which may cause numerical issues? Does he use integrators and limit their output? If he does limit the output does he counteract windup? If he uses neural networks, did he gather enough data that we can be sure that this things works?

There's so many pitfalls here where teams of engineers with the whole part spec and from different disciplines have failed before. It sounds very dangerous.

Fuzzing seems like a really useful test for this.

Either way, I agree I'm not really subscribed to the idea that DIY life critical systems are a good idea beyond POC.

Maybe it isn't life critical but only quality of life critical?

Insulin pumps are both.

If it pumps too much you're dead - which is why I'm considering it life critical.

Not enough is also bad but hopefully they'll notice and can act accordingly - still a threat too though.

It's not that we're all saying this is an unsafe machine, we're saying that a random person DIY'ing and using such a solution is very risky, there's a reason why commercial medical equipment requires rigorous testing/certifications, etc.

Usage of cheaper slow acting insulin becomes viable if it is controlled by an algorithm that knows your insulin level.

You can already use slow-acting insulin, it just requires planning your day out really well, which is hard and why slow-acting stuff sucks. The amount of data required to predict someone's glucose consumption/insulin requirements is massive, and needs to come from that individual. Then you'd need to build in overrides because people change their habits/behave spontaneously which puts them in danger. It isn't a simple problem.

That doesn't address his point, which is that a programmable pump isn't something you could sell because of the liability involved.

It is something you can sell, and is currently in development by major pharmaceutical companies.

Not end-user programmable, though.

I think the parent did not criticize the DIY community, only stating that different rules apply to biotech companies. I know many people who use the loop system and their health benefits immensely from it.

I will just say this. Someone in the openloop / DIY pump community is eventually going to die or seriously injure themselves (or a family member) doing what they do. It's not an if , but a when.

As long as this is someone who's actually working on the tech and knows what they're doing, this is only an unfortunate and very sad cost of progress. It's the risk they take, because they know they're doing good work.

This does become a serious problem when it gets into the hands of people who don't know what they're doing, if they're convinced to trust the tech because "obviously the smart people working on it made sure it's safe".

Still, parent comment stands. We might agree it would be better to do something, but regulation is regulation. To change that, you need to vote the right pers... Ouch, I guess that never works either.

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