Loop - my new build of FreeAPS - my mods and some questions

Tips, Tech & Gear Pump
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I have not done this in a while, but I wanted to get a new Loop version going. This is mostly for when I am traveling so I can have a safety net when I am alone.

I don’t like the normal setup where it looks at your IOB and cuts insulin all the time. I don’t ever enter carbs, so if I bolus for a large meal and there are no carbs entered, it freaks out. It thinks I took a bunch of insulin and didn’t eat, so it immediately cuts my basal. And it would leave the basal off for hours, based on insulin duration.

I have tried to make a workaround. I made a change so that I can set my insulin duration for as low as 15 minutes. By doing this, I am hoping Loop will only adjust basal for 15 minutes after I bolus, and after that, once it thinks all the insulin is gone, it will just go back to my normal basal.

Previously, the minimum insulin duration you could set was 2 hours.

Anyway, hopefully that will work better for me.

A few questions to start though.

It looks like I can’t setup more than one basal profile. Any ideas if that is something I could add?

Another question.

Not sure if I can set a temp basal that does not involve the Riley link or closed loop. Like I know I can use a new BG target as a TB, but I would like to be able to set an zero TB for a certain amount of time, without needing to be in closed loop or have the Riley link.

Just to confirm - does this custom basal thing require the Riley link?

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Also, you can’t set it below 35%, so I guess I need to find that in the code and rebuild it.

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Well I figured this one out. You have to turn Loop off first (go to open Loop mode). Once you have done that, you touch the top-middle of the app (where the basal amount is shown).

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After that, you get to the screen that lets you setup a temp basal.

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Anyway, it’s not intuitive, but once you know how to do it, it’s easy to setup a temp basal that does not need the Riley link.

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What hardware setup does this pertain to?

iPhone/omnipod ???

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You can loop with either a specific old version of Medtronic, or the UST400 version of OmniPod (not the Dash version).

I’m using OmniPod and an iPhone.

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Here is a question for what I am seeing now. Not sure who all the Loop people are… :thinking: @ClaudnDaye, @Trying, @TiaG @CatLady

In general, Loop only provides value for me when I am sleeping. So I am just referring to what happens there.

After I wake up and look at my Dex, I see a trend of climbing, and it is followed by a crash.

So obviously Loop is giving me too much for the spike, and that causes a crash. And it is obviously not giving enough insulin to prevent the spike in the first place.

Basically it seems to be causing me both the spike and the crash!

What is the best place to adjust for what I am seeing?

  1. Insulin Sensitivity
  2. Micro-bolus - “Partial Bolus Application”
  3. Micro-bolus - “Basal Rate Multiplier”

Anything else I am missing?

Here is an image to kind of show what happens.

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Maybe the better way to do this would be to just remove all the micro-boluses, and tell Loop, “Look, leave my insulin alone unless I go below 60!”

How would I set that up? Turn off micro-bolus, and set my duration to 15 minutes and my suspend number to 60?

That might work, right? It would not allow Loop to prevent spikes, but really the more important thing for me is to prevent drops.

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I have had the most luck adjusting the ISF in these cases. I would change the ISF beginning from 5AM…moving the number UP (from 100 to 105 for instance to tell loop that 1 unit is bring you down 105 points instead of 100.) That will cause loop to give you less insulin from 0500 - 0700 and result in less of a crash later.

ISF has been our MOST CRITICAL factor…just small number shifts to the tune of 1 digit either way makes a massive difference for Liam.

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Thanks @ClaudnDaye! I will try adjusting that.

I don’t know if you saw my next comment yet when you were posting, but what do you think about setting it up to only prevent lows? How would you go about doing that?

The reason I wanted to get Loop going again was for when I am traveling. I can handle highs, so the main thing is for it to prevent lows as a safety net when I am alone.

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9

I don’t know of a way that you can eliminate the micro-boluses without reverting back to the main branch and moving off of the FreeAPS/MicroBolus Dev branch. We moved to the micro branch BECAUSE we wanted those micro boluses…without them, the highs are much higher and much longer. I think you may find if you eliminate them, you’ll go higher longer as well.

The scenario you posted above; however, we encounter frequently and small ISF tweaks do two things…because you’re going to be getting less insulin from 0500 - 0700, that means you have less in your system to cause you to go low. If you find the right ISF number, instead of going up then back down again quickly, you’d get more of a level line for that timeframe. Less insulin from 0500 - 0700 would cause little/no drop later. We have had this scenario many times and ISF has always been our fix for Liam. Small tweaks…test and adjust again if it’s not enough, or too much.

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I tried Looping when I was on the Dexcom G-5, which was not sufficiently accurate and missed some lows. Also, I realized my settings were not properly tweaked so I did not continue Looping. Good luck finding a fix: lows when alone can be scary, for sure.

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11

I can try to fine-tune it over time. To make it remove both highs and lows.

But right now I have an immediate need for when I am alone (which is coming up very soon!), and trying to prevent lows.

So I want to come up with a simple strategy where it acts as a safety net. I don’t need to have perfect BG, just don’t want to be in a hypo-sleep in a hotel room where the room-service maid might find me 3 days later.

So just looking at removing lows when I am asleep, how about this?

If I were to make my target BG range 70-350, it would no longer give me any extra insulin ever. The only thing it would do is stop basal insulin when I got below 70, right?

Does that sound like it might work?

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Yes, in theory that sounds like it would work…not sure what reality would look like for it, though!

What about temp overrides for those time slots giving yourself 50/90/100% less insulin during the concerning timeframes?

Or just suspend the pump altogether?

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Well, I could just use the normal PDM and give myself a temp basal at a lower rate. That’s what I have done when traveling recently, just create a TB at 25% less.

But I figured Loop might allow me to do it a little smarter.

A lower TB on the normal PDM generally causes a high. I want Loop to only prevent a low.

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Do any of the Loop support communities address this problem?

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I don’t know cuz I’m not on Facebook. I am on FUD though!

Not 100% sure, but I think all the Loop things are Facebook.

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I found bugfixes and other talk on https://loop.zulipchat.com/

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Thanks. It looks like something I need to sign up for to be able to read it.

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Me, neither! :sunglasses:

As @bkh notes, you can get help even when you are not on FB.

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I don’t find it particularly invasive, you can make a local login without tying it to any social media accounts or otherwise having it follow you around the internet.

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Yes, I monitor zulipchat, too, and it is not invasive at all, but yes, you do have to sign up for it.

Are you on the Loop Master branch, Eric? Not FreeAPS, right? If you are on a recent Master branch you can choose whether to use autobolus or to use the legacy temp boluses (by the algorithm). I always use the autobolus mode, even for running. I almost never change my settings for ISF, etc. But I do use overrides to get through inconsistencies of variable ISF, etc., caused by whatever! I think the overrides is most convenient. You could create an override to help w/ lows overnight. For example,

Overall Insulin Needs: 70%
Target Range 90-100 mg/dL
Start Time: 10 PM
Duration 8 hours

This means you will only get 70% of your scheduled basal. If the algorithm predicts you will go under 90, it will suspend or reduce your basal further. If it predicts you will go over 100, then it will give autobolus (if autobolus mode, or increase basal temporary if temp mode), 'til the algorithm predicts you will stay in target range. And finally, if it predicts your BG is in range, then you get your normal basal (30% reduction with this override). Of course, this is re-calculated every 5 minutes.

So for overnight lows, when traveling, it might be a good idea to have the target range 90 or above. I know I’ve had some very dangerous lows traveling for work, and would not want to re-experience those! Yes, if you set the high end of the target to 350 then you will only get your basal, also safe idea, as long as you don’t mind the spike if basal is insufficient.

The Suspend Threshold setting is the setting which will stop basal. I have mine set to 50 mg/dL since I don’t like to be without insulin. But you could set that to 70 and then Loop will suspend all basal if BG is predicted or at 70 or below.

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