The commercial systems have to be cautious about dosing insulin, because if they give too much and you go hypo, there’s no way for them to save you and it’s their fault for giving too much insulin. And that could have legal implications.
That’s why I use the Loop software. It was made for treating diabetes by people who are treating their own (or their child’s) diabetes. So it tries very hard to be safe, but ultimately it supports you doing whatever you want, because you are fully in charge and responsible if you decide to download non-FDA-approved open-source software from the internet and put it on your phone to help dose your insulin. Personally, I view the insulin dosing as a cooperative activity between me and the Loop software, rather than wanting Loop just to take care of everything all by itself. It took some time, but I have learned how to guide the Loop algorithm to work with me to give the insulin that I would choose, and to do a pretty good job even when I’m not paying attention.
I don’t see the harm in giving it a try. Ultimately it’s up to your personal preferences as to which will be easier and more comfortable. Some people get better results from Control-IQ by keeping the algorithm in sleep-mode pretty much all the time, and adjusting the settings (basal, sensitivity, carb ratio) to push the algorithm to give better BG results. You’d have to search for advice on that, though, because I’ve never used Control-IQ.
When I switch pumps, I generally start with whatever my true basal requirement is. Then after watching what effect that has on my BG, sometimes I modify the basal schedule a bit to push the dosing algorithm closer to the dosing decisions that I would make for myself.
Thanks for addressing my questions. I sure do appreciate it. Loop sounds exactly like what I would like to do. I do not want to surrender 100% of control to anything and I’m willing to work and help along whatever technology can help me. And I guess that’s why I’m a little frustrated it’s just because I want to push it to do better but like you said, the algorithms protect the companies from litigation. I will certainly look in to looping software and do some research here on this site as well to find out what people are doing and what to download for my purposes. First, I’m gonna have to get my own basal set up so that I know really what it is. I really appreciate you taking the time to address each of my questions. Thanks and have a great day!
Be aware that setting up loop isn’t a straightforward plug and play solution. You may want to read a few of the stories on our site about the effort required to loop before committing to this approach. If you are the proactive person who wants to really dial in your treatment and are willing to do some extra work then looping is by far the best way to achieve your goals without any interference from the big companies and their safety margins. But it is a fair bit of work until you get it dialed in.
Again lots of info on our site and help if you want to go down this path.
Thanks Chris. I think I am a bit inundated with information and ever more questions right now. I’m going to approach looping very slowly. I think I still have so much more to learn about Omnipod and site placements and things like that. So I’m feeling a need to slow down a bit right now. Thank you for the reminder that it will require attention and work and I will begin looking into it, and just taking my time learning, and then we’ll decide when the time is right. I appreciate your insight.
@Quadgirl Sounds like you’re doing a good job of your own research and seeking advice from knowledgeable people. Not pound you on the head, but I echo @Chris’s comments: research Loop before you jump in, because he’s right…it’s not for everyone and that’s coming from another Loop advocate like @bkh. In particular (and I’m not an instructions kind of guy), “Read the [docs] first (LoopDocs)…all of them!” Not so much the “how to build it”, but how it works, what it works with (CGMs/pumps/other software), and what settings do what. For instance: Loop contributes to and uses Apple Health info; if other programs also contribute certain data there, you can end up with an un-intended “double” insulin dose by Loop and if you don’t know or notice and you’re somewhere without enough fast acting carbs it could be life threatening.
If you decide its a good fit, then continue your education on options to build and install it. Read how to set settings and refine them (search for “Kenny Fox loop” or “loopandlearn” on YouTube, or go to https://www.youtube.com/c/loopandlearn and look at the resources tab). If anything isn’t clear, post a question here, on the Looped or LoopandLearn Facebook page or on LoopZulipChat (may require an account).
AFTER you’ve researched and IF it feels right, THEN jump in.
(God, I really sound like some old codger…hey, I AM an old codger!)
Well, …, maybe it’s not quite that dire. The default settings for Apple Health in Loop allow Loop to write BG, carbs, and insulin delivery into the Apple Health data, but Loop is normally set to read BG and insulin from Apple Health, and not carbs.
Now, if I were to override that and switch on the “allow Loop to read carbs” from Apple Health, and if I had some other app that adds carbs into Apple Health, then Loop would see those other carbs and start dosing for them, and if I also put those carbs into Loop they would appear twice so Loop would give a double dose of insulin. So the situation is not quite as dire as “sometimes Loop will give an unintended double dose of insulin,” and it’s more along the lines of Loop has lots of settings you can change, and if you choose to change them without understanding what they do, you can get yourself in trouble.
That said, I fully support the advice about not racing heedlessly into a software system that automatically doses insulin without your say-so, until you have done enough reading to understand what you are getting into.
Sorry if I made it sound that “dire”, my intent was to say “be careful and do your research.” People using both FDA and non-FDA approved devices …pumps, CGMs, smart pens, software, etc., need to understand how they work, how they don’t work, what they use to make them work. I think most of us tend to believe testing has been done and shown something safe…right up until that “one” combination is found that makes them not work or work in unexpected ways…the genesis of “don’t buy version 1.0 of anything!” With the connected nature and interactions of hardware and software today, testing all the combinations and permutations is difficult and time consuming IF possible. We who are literally trusting our lives to software and hardware need to be informed and confident of our capability to monitor and adjust…it’s daunting, sometimes very rewarding!
Thanks, TomH! I appreciate the insight. I realized I am still trying to think like a pump, so premature to jump right in to looping. I do think I will end up there, but no time soon and not before I have gone through all the various learnings. I have been fighting with and blaming Omnipod while forgetting that there is no long-lasting Tresiba in me when I finish exercise on zero and that pre-bolusing times and even bolus amounts may need tweaking. So I will think like a looper well down the road. I got too brave for my britches having been on the pump for a mere 2 months. So, your comments and advice are well appreciated. Plus, I realized I am not ready to add more apps at present. I am sure waiting for iphone app for OP5 - hate carrying 2 devices, so that one I want. Anyway, thanks a bunch!
Amen to all of that. There is so much to know, besides our own bodies not behaving as expected all the time. I make tons of notes about all the settings changes I make and my own reasoning for them. Helps keep me focused and not feeling so random, especially on days when I want to throw the baby out with the bathwater and make too many changes or mull stopping the pump altogether. Sage advice to get educated first and then apply to one’s own body and then adjust more for the ins and outs experienced. Thank-you.
