Benefits of Looping

I currently use the G7 and Mobi pump and would like to understand more about looping and the various apps that support it. Can someone explain the benefits to me given what I am currently using? About 8-10 years ago, when I was using MDI and G4, I did use XDrip for a while on my android phone. So I understood the benefits then. But I am not sure what they would be now.

Any info is greatly appreciated. Thanks

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So you are already familiar with the Tandem Control IQ closed-loop algorithm.

Looping is just another way of doing that, but it gives you more control over what settings you want.

With Control IQ, I think you can only set a target of 120 or 150, or something like that, right? Looping lets you set whatever target you want.

Similar to the way Tandem works, you set your basal rates and BG targets. But you can set them for whatever you want.

When you are in closed-loop, the app will give you more or less basal depending on what your CGM number is. And it will also give you micro-boluses if your BG is high enough.

If you switch it to open-loop, it just follows your pre-programmed basal rates. It does not make any changes if you are in open-loop.

Advantages:
You have one less device to carry. It all runs on your phone, and most people always have their phone with them anyway. You don’t need to carry a pump around. (Although with the Mobi, it’s kind of the same thing there, since Mobi runs from your phone.)

The other advantage is that you have total control over the settings. Your BG target can be anything you want.

Disadvantages:
You have to use Omnipod Dash. I think Dash is fine, but if you are not used to it, it might be an adjustment to switch to it.

You have to build it yourself. It takes some time to learn how to build it. It’s not too hard, but just takes patience and reading. And you can ask people here for help.

Thanks Eric. Aren’t there other open source options that do not require switching to Omnipod Dash?

Can you clarify this? I thought the pump and phone always have to be close to each other.

If you are talking about looping in terms of a commercial pump, all 3 of the big pump manufacturers now do this - Medtronic, Tandem, and Insulet (OmniPod). There is also iLet, which is not one of the big 3, but they also do it.

If you are talking about a do-it-yourself loop system, you can do this with either iPhone or Android. There is code available that allows you to do it with either type of phone.

But you need a pump to go with the do-it-yourself loop system. As far as I know, the only pumps that work with this are OmniPod Dash, and very old discontinued versions of the Medtronic. You might still be able to find one of those Medtronic pumps, but it’s not easy because they have not been made in quite some time.

Unless there is some other option I am not aware of, I think those are the only 2 options. :man_shrugging:

Someone please let me know if I am missing something on this.

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@funk It has gotten to the point there is not an easy answer to your question, because the environment of ā€œloopingā€ (small ā€˜l’) has become diverse. It depends largely on what phone/OS you have and what country you’re in to determine what pumps and CGMs are available and what AIDs work with them. @Eric has provided a good basic review of Tandem and commented on Dash pods; Dash pods are the favorite for looping software because the security of the pumps BT signal is known, yet considered relatively secure. In the US, the primary platforms for looping (small l) using DIY apps are Loop (large ā€œLā€, V3.6 just came out, requires iPhone/iOS), AAPS (not sure of current version, requires an Android phone), Trio (currently in beta testing w/a small group, public beta due out soon, its an offshoot of iAPS, requires iPhone/iOS), and iAPS (not sure of current version, changes more frequently than most, I believe still requires iPhone/iOS). Most DIY iAIDs are compatible with a varying set of iCGMs (most support Dexcom G6/7, many support Libre 2/3, several others are supported dependent on the iAID software); some are compatible with varying pumps (Dash is the primary for Loop, Trio, and iAPS [I can’t speak to AAPS as I’m not sure). Commercial pumps state they are ā€œloopable,ā€ but true capabilities vary depending on your definition of ā€œloop.ā€ Some allow a BG range higher than many people want, some allow a limited correction factor, some are a ā€œblack boxā€ (i.e. you don’t know what the algorithm is); the list goes on. In addition, some are available via ā€œpharmacyā€ benefit channels (current Dash pods are one), some only via DME (Durable Medical Equipment) channels (Tandem and Medtronic are examples). If you live outside the US, the number of available pumps, their manufacturer iAIDs, compatibility with DIY iAIDs, and compatibility with iCGMs varies even more.

On the good side, the options available for iAID software, iCGMs, and pumps is growing. It seems some pump manufacturers have broken the code that people expect pumps to work with multiple CGMs and AIDs, vice stove-piped into manufacturer vertical monopolies. Example the new Twiist pump, using a commercial version of the Loop code, is due out by EOY 2025 and is supposedly going to be compatible with both the Dexcom G7 and Eversense 1-Year, possibly the Libre 3. On the DIY AID side, the community has long sense broken that code and has expanded software to be compatible with multiple CGMs and pumps for some time and it’s growing to support more.

The best advice is to do your own search. Check what pumps are approved for use in your country, then check what AID software will support those pumps (commercial or DIY) and what CGMs are readable by the AID software. The one differentiating item is what support there is for the combinations available to you and what are your abilities to handle the combinations. Is DIY a realistic option for you? Is commercial and hands-off what you need/want? It’s not quite the defined commercial environment it once was, and the DIY environment isn’t quite the Wild West it once was either. We can be thankful the #WEARENOTWAITING folks pushed both the commercial and DIY markets!

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Tom and Eric

Thanks so much for all this info/feedback. I think I am going to have to sit down with a glass of wine tonight and read thru all of this very carefully. There is a lot out there and I hadn’t realized I was asking such a loaded question.

Thanks again and I may be back with more questions!!

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Any questions you have are welcome! FYI, I’ve used Loop, iAPS, and Trio. I’m currently a beta tester for Trio. I’ve used both Apple Xcode and Browser Builds for each (it takes time the first time and ability to carefully follow directions); subsequent browser building is easy. There’s plenty of help available on FB, GitHub, or Discord. I’m not a programmer and it doesn’t take one to do it. There is a cost: you need an Apple developer account, $90/year. I have not used a commercial AID/looping system or tubed pump (Dash was my first and only). I should have included that Loop (I think Trio and iAPS too) can use older Medtronic pumps (pumps may be out of warranty), not sure if newer variety will work with it/them. Some people swear by commercial systems (like Omnipod 5), others swear at them. YDMV is the catch phrase. Hope your research takes you in the right direction for you!

Newer Medtronic pumps do not work. The older ones that do work are hard to find now. They are highly sought after online because they allow looping.

If you find one of the older compatible Medtronic pumps being sold online, it would go for an exorbitant price. I think they were the Medtronic MiniMed 515 and 522, and a few other old Medtronic models. I don’t recall all the numbers.

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Trio also supports the Dana RS/-i pump.

While AndroidAPS supports a number of other pumps besides Dash, Medtronic and Dana pumps.. I believe it also supports Medtrum, Tandem t:slim and Ypso pumps.

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Is it available in the U.S. now? For a while I think it was only available in Europe. I did not know if that had changed.

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Trio, Loop and AndroidAPS all support Dana RS / i pumps. I believe Dana i pump is FDA approved.

From Diabetech posted in 2022:

  • The Dana-RS pump is the older version of the Dana-i and will probably not be started anymore.
  • The Dana-i is a good catheter pump, although the interface of the pump feels outdated. The pump should be ā€œmore affordableā€ than comparable insulin pumps. It is available in Korea, Asia and New Zealand. Availability/use in Europe is limited (UK, the Netherlands and Luxembourg). It has an FDA-label, but is not used in the US yet.
  • Ypsopump is a small light weight catheter pump that works with insulin Pumpcarts and has a unique infusion set that rotates 360 degrees. Ypsomed has integrated the CamAPS FX algorithm in their mylife Loop system. If you are choosing or offered an Ypsopump, its therefore more logical to choose the more integrated mylife Loop system (view below).
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Thanks @Trying. Yes, that’s :arrow_up: what I saw which I was referring to.

Basically, it would work if you can get one, but it was not widely distributed yet in the U.S.

But that was a few years ago, so it might be easier now.

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Yes, there are users but I’m not sure who is in the US. I just know that the developer is very responsive in integrating it with Trio and other loop AID systems.

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