A Little Intro

Where to begin?

I’ve been a type 1 diabetic since I was 5 years old, I’ve never really known life without it. I work in IT so I have always had an interest in technology and I’be been following diabetes tech since the days of a Jet injections, the glucowatch and I have been on a pump since I was 17, I’m now 34 and using Ominpods.

A couple of years ago I tested the G5 CGM’s, they were amazing. A full 24 hour of monitoring with only a couple of calibrations. Now the G6’s are here, they are smaller with no (although I do a couple) calibrations.

Now for the fun. a couple of years ago I started reading about closed loop systems, in place of a cure they seem the next best option. I read as much as i could, i saw they were making it work with Medtronic pumps and a G6 and they were working on the Omnipods. In preparation I ordered a Rileylink as that is the key piece of tech to link my phone with a G6 to my Omnipod.

The software was released last month (May 2019) and this month (April) I took the plunge. I’m going to note down day by day how it goes for me. This might end well, this might end badly. Let’s see what happens.

Day 4

Starting to get used to the loop and enjoying it. Connecting it up to Nightscout makes all the reporting work and look good.

I’m very apprehensive about introducing this to my diabetes center the reports from Nightscout should make them happier. My appointment isn’t until late July so I will approach that later.

My night times still run a bit high at times and I don’t think I’ve trusted it enough to allow it to put more insulin in automatically. Maybe in the future I’ll give it more but for now I’m happy with what it’s doing.

I’m still running a bit high during my 10 mile cycle to and from work but I’m going to manage that next week when I have some more experience with the Loop.

Day 3

I woke up at 14 mmol/L, the app was not connected to the pump as the RileyLink was too far away. I’m using the first gen RileyLink and I know there is a newer one out with better range. I hold the RileyLink nearer to the pump it connects up and the advice is to put in a correction bolus.

The daytime goes well, I bolus for food I’m eating and if I get the bolus a little wrong it advises on the correction.

Nightscout wasn’t displaying as expected, I went over the config again and had missed some of the config variables. I should have read the guide better. After adding them all in, the data started to flow through properly. I want Nightscout as this is how I will present data to my diabetes team as there doesn’t seem to be a nice way to give them the insulin usage apart from this.

I’m getting impatient now, I can see what the app is wanting to do and every time I’m approving it. I’ve decided to close the loop over night and see how it goes. I make sure the limits are set, my phones have power and the RileyLink is as close as possible.

Day 2

I began the day as I left off the last day, the app was running and controlling the pump nothing more.

By midday however i has setup Nightscout to get some reports and also linked up the G6 CGM via the cloud share function. My current setup looks like this – Omnipod connected to iPhone, G6 connected to Android and cloud sharing to link the 2. A tip here you need at least one person sharing the data before the cloud share function in the app works, I am sharing with myself.

Now the magic started to happen, I soon started seeing recommended basal rates. I was running in the open loop mode for testing to start with. They were only very small increases/decreases depending on how the BG trend was going on the CGM. They seemed very small but it became quickly apparent that the small changes were so regular that they could make a big difference.

I kept the open loop mode into the evening constantly looking and accepting the recommended changes. I was adding in food and it would advise on a bolus for that food and also predict where my blood sugars would end up. Towards night time my confidence in the system was building and I began to trust the app.

I’m keeping open loop mode for a couple of days and will then close the loop.

Day 1

I work in an IT dept and I much prefer Android to Apple.

Problem 1 – The app requires an Apple phone, a Mac and an Apple developer account. I was very lucky here, I swapped my work Android for a newish iPhone. We also have a business app that required a Mac and a developer account so I was able to use these to compile and deploy the app.

Following the instructions on the Loop docs page (https://loopkit.github.io/loopdocs/) I was able to download, compile and run the app on my work phone. The app looked sparse to begin with but i was so excited as the first step was done and looked to be working.

I spend a couple of hours going through every setting in the app, configuring my basal rate, ISF, etc etc.

The Pod I was wearing expired today so I sat on my sofa and thought it’s now or never. So I changed from my PDM to the phone app. It worked perfectly, i connected the phone to the RileyLink and the RileyLink saw the pod and primed it. The nerves were high at this point. I stuck the pod on and the canular inserted.

I stared at the app for hours wondering if was doing anything, I could hear the pod ticking so I knew insulin was going in.

Mistake 1 – With the PDM I was used to adding the carbs for a meal clicking ok and the pump then putting in the insulin for that. With the app they are separate, I put the carbs in that it was eating and assumed the corresponding insulin would be inputted. It wasn’t, I went high, very high. I correctly through the app when I realised this and life was ok again.

This was my first day with the app so I hadnt connected up the CGM, the app is pretty dumb without the CGM data. I was trying to edge in slowly to looping, i went went too slow.