awaywethrow

To clarify, the context of this thread / what I was originally responding to was:

> In this case, you could be more aggressive in either direction of pushing BG, because you have a safety net.

> Severe hypoglycemia to the point of what was described (death) is not reported in any of the recent device studies.

Are there large-scale studies that show this for a dual hormone control algorithm (the context of this thread)?

> It's also, of course, more to add to the patient's maintenance

I agree with all that you've said, and this point in particular is extremely important. It's also the reason I moved from a DIY system like the one mentioned here, to a commercial system, once the latter was available. There is simply less hardware and software to juggle with the commercial system. There are fewer knobs, bells, and whistles, meaning I might not be able to tweak things to be in as tight control as might be possible with a DIY system (though with risks!), but overall it's been "good enough" for me, and greatly reduces the cognitive burden of having T1D. My experience clearly doesn't match everyone's, but considering I'm typically someone who loves to tinker, and has plenty of T1D experience (engineer, 34 years with T1D), I'm sure I'm far from the only one that feels this way. My glycemic control isn't significantly better than it was when I did it via constant monitoring and mental math, but the cognitive and emotional burden is much lower.

My worry with this approach has been that infusion sites (both for insulin and glucagon) can become occluded, pulled out, etc. to suddenly render them completely ineffective, and that automated detection of these scenarios is not great.

You need to move forward, and therefore must occasionally have a foot on the gas (insulin). The gas pedal failing, causing you to stop moving forward, is not urgently dangerous (hyperglycemia). However, if your brakes (glucagon) can sometimes fail completely, that could cause you to die almost immediately if you're moving too fast toward danger (extreme hypoglycemia). Given this situation where brakes are unreliable, do you want your automated control system to rely on them and push you to dangerous speeds?

Your last four submissions are either about eBay (creators of Marko), or a creation of Patrick Steele-Idem (one of the maintainers of Marko). So... you tell us?