Omnipod Looping

That would be great.

Thank you very much. I will put this into my next build. I appreciate it!

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I am running my RL charge into the ground to see how long it really lasts.

I think it’s very useful to know.

In general I will try to charge it every night. But just like the car gas tank might show empty when there is still some gas in the tank, I like to know exactly how much gas is left in my car. And the only way to find out for sure is to run it until it’s completely empty one time. I’ve done that with all my cars.

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I also ordered a spare RL and just received it. I plan to carry the spare when traveling, just in case. :slight_smile:

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I will also re-build with these changes. I used the watch crown today for the first time to bolus during a run, and it worked well. The 0.05U increments makes good sense though :slight_smile: . Thank you!!

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I can’t remember all the peeps that are looping, but since this was a thread split from a running thread - and I know that was not germane to a lot of people here - I want to make sure all the people with Loop experience are invited to this thread to contribute.

@dm61
@Trying
@ClaudnDaye
@bkh
@TiaG (I know you are not Omni, but it’s kinda sorta the same thing)
@bpollina
@Millz

If I am missing anyone, please add them!

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Please let me know if this is a correct interpretation…

I think I can interpret this image that my basal settings are fairly decent.

There is a relatively close balance between the positive and negative adjustments that Loop is making. A little bit of back-and-forth on both sides, but in general it seems to be somewhat balanced.

Is that a good way of interpreting this image? Is there a better way of interpreting this? Is there a better way of analyzing it, such as looking at numbers somewhere?

Am I off-base with my judgment here? I have no idea, please let me know if this is a good way of analyzing this.

image

So… in general maybe the basal rate is okay. But the fact that it’s titrating on and off would make me wonder if the ISF is too aggressive. The Loop ISF is often very different from the manual mode ISF…

Also, do you know about autotune?
https://autotuneweb.azurewebsites.net/

It isn’t great to just hand over the reins to autotune but it can give you some ballparks to think on…

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The section under 3rd: Insulin sensitivity factor in the following link talks about the where temp basals are cycling between zero and high temping:

This could be caused by ISF being too weak. It is best for Insulin Delivery to show a flat line (no high and no low temps) for overnight when bolus is not a factor. If bolus is a factor than other settings like IC need to be considered. I know you do not input carbs though. Is this graph from overnight?

Besides Tidepool, Nightscout is another great tool. It has a Loopalyzer which displays graphs for temp basal, IOB and BGs.

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Just for clarification, are you both saying the same thing but using different words - “aggressive” and “weak”?

Or are you meaning the opposite?

BTW, I don’t have Nightscout.

And I don’t have a lot of data from Loop yet. Just a few days worth, so I will probably need to collect more before I can really figure it out.

I can see how the constant flipping back and forth between positive and negative is not ideal. But on the other hand, it seemed to do a better job of keeping me level after I made the changes.

"If your ISF is too weak (in other words the actual number is too low compared to reality of how strong the insulin is) in closed-looping, one of the most common symptoms you’ll see is a roller coaster of BGs where the temp basals are cycling between zero and high temping. "

Yes, you’ll probably want a week of data to use Autotune. Autotune works off the Nightscout data, so it would be good if you could deploy a NS site. It is free with Heroku, and really provides good insight into the data. You can select any period of days to view Day to Day which includes basal, bolus, BGs, overlayed on the graphs.

As long as the changes are keeping you in range, that is what is important!!

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So is that the same thing that @TiaG is saying?

I did artificially set the ISF lower so that Loop would be more aggressive in fixing spikes.

My basal rates are so variable, that I need Loop to be aggressive. I can’t let it passively bump up basal just a little bit hoping to stop a spike.

The difference in my basal needs from one day to the next are huge!

I have to read all the doc you guys posted. Just need to find some minutes for that.

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I’m saying that I see rollercoastering when, for instance, my ISF is 250 rather than 280. The former is “stronger” because 1 unit of insulin drops you only 280 points, meaning at the same high blood sugar, you’d get more insulin to drop you into range. I know, the nomenclature with ISF is annoying and confusing.

Is that what you’re saying @Trying?

I’ll also say you *can get rollercoastering if your ISF is too weak (i.e. the number is too large) but usually that’s paired with something else being wrong.

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Setting ISF to a smaller number to give more insulin for an elevated BG (which I call “stronger ISF” because it gives a stronger i.e. larger dose of insulin) is an intuitive approach to help loop fix sustained highs. I tried it when I started looping for the same reason you did.

Unfortunately, it doesn’t work. It forces the algorithm into oscillation. You’ll see a roller-coaster in the BG graph corresponding with the algorithm’s overreaction to changes in BG, alternately suspending too hard and dosing too hard. I use the strongest ISF that doesn’t cause oscillation, but it’s still not enough to bring me down as fast as I want, or at all if I happen to have temporarily elevated insulin resistance or too little basal.

I surf by editing the carb history to increase the number of carbs I ate and/or change the meal duration until loop suggests a correction that’s about the size I want, and predicts a future course of the BG curve that agrees what I think will happen. Then I take that correction, and loop is not perturbed because it’s exactly what the algorithm thinks I need. I know my approach is “wrong” and the designers of loop believe that if I simply give the right data then loop will do the right thing, but it seems that the parameters are too unstable in my body so loop often gets it wrong. So I just surf as needed; no big deal but not fully automatic either. Loop still reduces my burden considerably. For me, this is most salient when asleep or otherwise fasting, and when driving the car.

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My comment comes directly from the Loopdocs, and it is describing your LAST statement, that rollercoasting comes from ISF that is too weak! So we are using the same terminology, but just describing opposite results.

I do this, too, when I observe a temporary, insulin resistance, but I often experience roller coasting during this time period, too. I end up getting/maintaining range, but it takes a toll on me just the same as I am constantly monitoring the numbers.

I also use @bkh’s techniques by editing carb history. But that may not help you, @Eric, since you don’t enter carbs. You could enter “fake” carbs I suppose to get the prediction to be more inline with what your body is experiencing.

I almost never change my Scheduled Basal, although I do use the Overrides while exercising (pre/during/post) of course. I use only one Scheduled Basal, and that is fixed at 0.5U, so maybe I am lucky there, but it means that I do have to pay attention to the numbers when body requires more/less. Maybe I am confusing matters, but I think my changing needs seem to be due to temporary changes in insulin sensitivity and/or insulin absorption, not really basal requirements.

I think there is a difference in what people mean by “too weak ISF.” In the article by Katie DiSimone at Fine-Tuning settings – See My CGM we have the following statement:

I think that statement uses the phrase “ISF too weak” to mean that the ISF parameter set in loop is set to too small a numerical value, which causes too much insulin to be given, inducing oscillations. Unfortunately, I call this circumstance “ISF too strong” because to me the ISF is giving too strong a dose of insulin.

If we look past the difficulties with terminology, I believe it is fact that an ISF that causes too large a correction dose of insulin for a high BG can cause oscillation, and an ISF that causes too small a correction dose of insulin for a high BG will not cause oscillation.

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I wanted to share my goals and reasons for Looping. Because I imagine my priorities and reasons are not quite the same as many others may have.

I suspect that for most people who are doing this, the goal was better BG management. That makes sense. That’s pretty much what Loop is all about.

For me though, the reason is totally different. My primary goal was looking for an easier way to manage insulin delivery. Not only while running, but also from a hardware perspective - carrying a phone and RL and BG meter, versus carrying a phone and PDM.

I got very interested in the prospect of Looping when I heard the discussion about using a watch. And thinking about doing that while running. If the watch was not possible, I may not even be trying it. Using the watch while running was the thing that really peaked my interest!

As a secondary goal, if I can get it dialed in properly and it helps BG management at night, that’s great.

But anyway, I know that’s probably backwards from what others may be looking for. Possibly others were looking for better BG management first, and then ease of use second. I don’t know.

It doesn’t really matter much for our discussion here, but I just wanted to share my goals and my reasons to add to the overall content on the thread. :man_shrugging:

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yep, this is our approach too.
Using an artificially low number for ISF leads not just to lows when Loop piles on too much insulin, it actually leads to highs too, when, for instance, you start dropping and Loop freaks out and thinks “oh my goodness you’re crashing!!” and then turns off prematurely.

Surfing has been helpful but so too has the temp override function in the Jo Jo branch. What I find is that sometimes Samson just needs more insulin, and the static settings of Loop can only adjust so much if he needs almost double the normal amount of insulin.

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These arrived today, but they are too small. The RL antanae sticks out so can’t be zip locked. Otherwise, nice. Better to get the next size up in length.

Crap, I guess I screwed up. Sorry!

I’ll look around some more.

I think mine will be arriving today too. Oh well.
:tipping_hand_man:t2:

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They are still handy for other small items!