Why Type One Diabetes Patients Need Closed Loop Insulin Systems
By Juan Vittori, PR Specialist, 90 DIGITAL
For a while now there has been a heated debate surrounding hybrid and closed loop insulin systems. While there is only one hybrid system on the market that combines a glucose sensor and an insulin pump, type one diabetes patients are impatient for a closed loop system. So impatient in fact, that many of them have begun tinkering with devices and building their own closed loop systems to essentially hack their health and get the doses they need without having to rely on rough averages. Born on the forums where people share tips and information about living with type one diabetes, the We Are Not Waiting Movement has taken matters into their own hands.
The Hybrid System on the Market
The Medtronic MiniMed 670G is the hybrid system that is available only in the United States and won’t be available in Europe until the end of 2018 though it passed through the Food and Drug Administration (FDA) in 2016. Medtronic’s technology combines a glucose sensor, an insulin pump, and uses a safety-first approach. Though it communicates glucose levels to the insulin pump, the MiniMed can’t be customized or set to target glucose levels. Instead it uses rough averages to calculate the insulin dose.
The users of this technology complain that the Medtronic device does not prevent control blood sugar spikes and falls during key times, like meals and sleep. There are many alerts and notifications that are also problematic for them. They force users to stop what they are doing in order to adjust the glucose targets and insulin doses. Plus the system is expensive, it sells at $7,250 each.
However, what is intriguing about Metronic’s 670G is that it is safe and easy to use. The safety mode shows that Medtronic aimed to get the device passed regulators, it is conservative and careful. It requires training sessions, which still take less time and energy than building closed loop pump systems yourself. The Medtronic system works, but it comes at the high price of settling, and many diabetes patients believe they should not have to settle for less.
DIY Closed Loop Pumps
The do-it-yourself perspective of the We Are Not Waiting Movement has led to open source platforms for people to share information about how to build these devices and create perfectly closed loop systems that are accurate and fully automated.
Connecting cheaper technology, users can create a closed loop system that works for their needs at a percentage of the cost. By using a glucose monitor, an insulin pump, and phone application, people can combine these technologies into something new and more effective than what is available right now.
Although the app is usually free, the Bluetooth hardware can cost a small fee. RileyLink, iPhone’s Loop software, communicates the information from the glucose sensor with the insulin pump via Bluetooth. Similar to iPhone’s technology, Android uses their own app to control settings and customize levels. Another option is OpenAPS, which uses a small computer to communicate glucose information to the insulin pump.
All of this information is available online, making it easy for anyone to build, set up, and use these devices. This is what makes medical professionals nervous about do-it-yourself pumps. Even if you have technology skills, you may still run into problems you don’t know how to solve. Not having technology capabilities puts you at a higher risk. As diabetes patients know, too little or too much insulin can lead to danger. As a medical negligence firm explains, since these devices are not approved by regulators, there is always risk involved in building your own, though you may be successful.
Managing the Risks & Contemplating the Benefits
Building and maintaining your own closed loop insulin pump can very beneficial to the patient. The risks lie in the technological capabilities of the patient. Doctors should talk to their patients, learn about their technological skills, make sure they understand their algorithms, and help make the right decision for them.
When using a system that you built yourself, you need to know how to respond to problems you may encounter. Blood sugar levels for those with diabetes are sensitive and the patient should show caution when building a device to treat themselves. It is crucial that people understand what they are doing, how the automation works, and that they need to re-validate the system whenever applying new code. But if you go about it the right way, closed loop systems are the best solution for type one. Until the manufacturers and regulators can get closed loops systems on the market at an affordable price, patients will continue to treat themselves. Necessity is truly the mother of invention.
There is no beating the price, custom abilities, and accuracy of a closed loop artificial pancreas. Closed loop systems are better for handling type one diabetes than hybrid pumps. It is simply up to the manufactures and regulators to provide this technology to the people who need it.