2 year experience of 'Do-It-Yourself ' Hybrid Closed Loop in an adolescent with Type 1 Diabetes

2019 ◽  
Author(s):  
Shankar Kanumakala ◽  
Peter Lynton
Keyword(s):  
Type 1 Diabetes ◽  
Closed Loop ◽  
Do It Yourself

scholarly journals Appearance of Do‐It‐Yourself closed‐loop systems to manage type 1 diabetes

2018 ◽  
Vol 48 (11) ◽  
pp. 1400-1404 ◽  
Author(s):  
Tien‐Ming Hng ◽  
David Burren
Keyword(s):  
Type 1 Diabetes ◽  
Closed Loop ◽  
Closed Loop Systems ◽  
Do It Yourself

scholarly journals Safety and glycemic outcomes of do-it-yourself AndroidAPS hybrid closed-loop system in adults with type 1 diabetes

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0248965
Author(s):  
Andrzej Gawrecki ◽  
Dorota Zozulinska-Ziolkiewicz ◽  
Magdalena A. Michalak ◽  
Anna Adamska ◽  
Michal Michalak ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Body Weight ◽  
Closed Loop ◽  
Insulin Pump ◽  
Severe Hypoglycemia ◽  
Insulin Requirement ◽  
Time In Range ◽  
Do It Yourself ◽  
Glycemic Outcomes

Background The aim of the study was to assess the safety and glycemic outcomes with the use of a Do-It-Yourself (DIY) Hybrid Closed-Loop (HCL) system based on the AndroidAPS application in type 1 diabetes (T1D). Methods Single-center clinical trial, with 3-week run-in and 12-week study period. DIY HCL system consisted of the Dana Diabecare RS insulin pump, Dexcom G5 continuous glucose monitoring system and AndroidAPS application. Primary outcome was safety: incidences of severe hypoglycemia, diabetic ketoacidosis, time spent in glycemia <54 mg/dl. Secondary endpoints included percentage of time in range (TIR) 70–180 mg/dl, time below 70 mg/dl, HbA1c, insulin requirements, and body weight. Results In total 12 subjects (5 men, 7 women) were enrolled, mean age 31.3±6.7, 95%CI(27.7–34.9) years, mean diabetes duration 16.1±5.7, 95%CI(13.0–19.2) years. No episodes of severe hypoglycemia or ketoacidosis were observed. Percentage of time spent in glycemia below 54mg/dl was not increased. Average sensor glycemia was lower in the study period than baseline (141.1 ± 8.4, 95%CI(136.3–145.9) vs. 153.3 ± 17.9, 95%CI(143.2–163.4), mg/dl p<0.001). TIR 70–180 mg/dl was improved by 11.3%, 95%CI(2.8%-19.8%) (from 68.0 ± 12.7 to 79.3 ± 6.4%, p<0.001), without increasing hypoglycemia time. The HbA1c level decreased by -0.5%, 95%CI(-0.9%–-0.1%) (from 6.8 ± 0.5 to 6.3 ± 0.4%, p<0.001). Additionally, in the last 4 weeks of the study period participants significantly improved and showed TIR 70–180 mg/dl 82.1 ± 5.6%, 95%CI(78.9–85.3), time <54 mg/dl 0.30 (0.20–0.55)%, median 95%CI(0.1–0.7) and <70 mg/dl 1.90 (1.10–3.05)%, median 95%CI(0.7–3.2). The insulin requirement and body weight did not change in the study. Conclusions The study revealed safety of the Do-It-Yourself HCL system AndroidAPS in adults with T1D, limited to well-controlled, highly selected and closely monitored patients. The use of AndroidAPS significantly improved HbA1c, time in range and average sensor glycemia without increasing hypoglycemia. As both patients and their medical team are gaining experience using the system over time, they improve glycemic control. Trial registration German Clinical Trials Register: no. DRKS00015439; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00015439.

scholarly journals Do‐it‐yourself closed‐loop systems for people living with type 1 diabetes

2020 ◽  
Vol 37 (12) ◽  
pp. 1977-1980 ◽  
Author(s):  
L. Dowling ◽  
E. G. Wilmot ◽  
P. Choudhary
Keyword(s):  
Type 1 Diabetes ◽  
Closed Loop ◽  
Closed Loop Systems ◽  
Do It Yourself

scholarly journals Exposure to Closed Loop Barriers Using Virtual Reality

2020 ◽  
Vol 14 (5) ◽  
pp. 837-843
Author(s):  
Monica Lanning ◽  
Jessica Shen ◽  
Daniel Wasser ◽  
Scott Riddle ◽  
Bianca Agustin ◽  
...  
Keyword(s):  
Body Image ◽  
Type 1 Diabetes ◽  
Virtual Reality ◽  
Closed Loop ◽  
Daily Lives ◽  
Glucose Levels ◽  
Diabetes Technology ◽  
Do It Yourself ◽  
Willingness To Use

Background: Closed loop (CL) automated insulin delivery systems are demonstrated to be safe and effective in regulating glucose levels and reducing cognitive burden in people with type 1 diabetes (T1D). However, given the limited market options and the do-it-yourself nature of most systems, it can be difficult for potential users to shape their expectations fitting them into daily lives and management routines. As such, we examined the potential feasibility of a virtual reality (VR) intervention. Methods: A four-part VR intervention was created to expose adults with T1D to expected CL system barriers: body image, perceived hassles of using CL, deskilling fears, and unwanted social attention. Goals of the pilot were to assess feasibility and expose patients to CL. Surveys were conducted pre- and postparticipating in the VR experience. Results: A total of 20 adults with T1D completed the pilot. Average time to complete the experience was 14.1 minutes (8.8-39.9). Reported VR sickness was low. Willingness to use VR was maintained in 90% ( n = 18) and did not change expectations of CL in 95% ( n = 19). Virtual reality changed perceived hassles of CL in 25% ( n = 5) with four concerned over alarms and one connectivity issues: positive diabetes technology attitudes, confidence in managing hypoglycemia, overall perceptions of appearance, and positive affect maintained after the VR intervention. Negative affect significantly decreased after exposure and perceptions of being overweight trended toward significance. Conclusion: This pilot VR intervention demonstrated high potential in addressing expected barriers to uptake and usage of CL systems without decreasing enthusiasm or changing expectations of CL.

scholarly journals Do-It-Yourself (DIY) Systems in Diabetes: A Family and Provider Perspective

2020 ◽  
Vol 14 (5) ◽  
pp. 917-921 ◽  
Author(s):  
Malinda D. Duke ◽  
Ashley A. Fredlock
Keyword(s):  
Type 1 Diabetes ◽  
Patient Autonomy ◽  
Closed Loop ◽  
Healthcare Providers ◽  
Burden Of Care ◽  
Glucose Levels ◽  
Closed Loop Systems ◽  
Provider Perspective ◽  
Do It Yourself

Type 1 diabetes is a unique disorder, requiring constant and vigilant assessment of glucose levels, food/snacks consumed, activities and exercise, emotions and stress, hormonal influence, and illness. No other diagnosis is as intensive in terms of the “burden” of care that impacts the patient/family physiologically, cognitively, and psychologically. Several Do-It-Yourself (DIY) closed-loop systems currently exist and can provide options for patients and families looking to reduce the burden of type 1 diabetes. However, as the systems are not Food and Drug Administration approved, healthcare providers are faced with the decision of whether to support patients using DIY systems. This manuscript discusses the ethics of choice and patient autonomy from the perspective of patient/family and healthcare provider. A set of proposed guidelines for healthcare providers are also presented for consideration when interacting with a patient or family who desires to use a DIY system to help manage type 1 diabetes.

scholarly journals Do-It-Yourself (DIY) Closed Loop Systems: Perspectives of an Endocrinologist

2019 ◽  
Vol 14 (6) ◽  
pp. 1104-1106 ◽  
Author(s):  
Tien-Ming Hng
Keyword(s):  
Type 1 Diabetes ◽  
Closed Loop ◽  
Closed Loop Systems ◽  
Do It Yourself ◽  
Alternative Choice

Do-It-Yourself closed loop systems are becoming increasingly popular as an alternative choice for managing type 1 diabetes. In this commentary, the issues that are faced by both the clinician and the person with diabetes are discussed from my perspective.

Patients’ Experience of New Technologies and Digitalization in Diabetes Care in Germany

2021 ◽  
pp. 193229682110413
Author(s):  
Bernhard Kulzer ◽  
Lutz Heinemann ◽  
Timm Roos
Keyword(s):  
Type 1 Diabetes ◽  
Online Survey ◽  
Closed Loop ◽  
New Technologies ◽  
Personal Responsibility ◽  
Research Question ◽  
Advantages And Disadvantages ◽  
Closed Loop Systems ◽  
Do It Yourself

Background: Little is little known about how people with diabetes experience advancing digitization and new technologies in diabetes. Research question: What are the attitudes of people with diabetes (or, in the case of children with diabetes, their parents) toward digitization and advancing technology in diabetology? What significant advantages and disadvantages do they see, and how do they assess current developments of digitization in diabetology (eg, hybrid closed-loop systems, do-It-Yourself (DIY) closed-loop systems, data protection, and data donation)? Material and method: 3,427 people with diabetes (47.7% female, 65.6% type 1 diabetes (T1D), 25.5% type 2 diabetes (T2D), 8.1% parents of children with diabetes; 0.8% other type of diabetes, age 49.2 ± 19.3 years) were interviewed with an online survey. Results: Overall, survey participants had a very positive attitude toward digitization (82.6%) and considered the potential for optimizing diabetology through digitization to be very high (78.8%). The highest rated advantages of digitization were “greater personal responsibility and self-determination in therapy” (80.0%), “better quality of treatment” (80.0%), and “better communication with the doctor/diabetes team” (77.3%), while the highest rated disadvantages were the “error-proneness of digital applications” (35.9%), the “risk of misuse of patient data” (32.3%) and the “fear that digitization will replace the doctor in many cases” (31.1%). The possibility of evaluating and analyzing glucose data by means of software, and AID systems, and the possibility of improving the interoperability of the various applications are currently rated as the most significant topics. Conclusions: The vast majority of people with diabetes are very positive about new technologies in diabetology and expect that it will improve and simplify their diabetes therapy and reduce the burdens associated with diabetes. In particular, people with type 1 diabetes have high expectations for AID systems, viewing them as a kind of “technical cure” for their diabetes.

Safety and Performance of the Omnipod®Hybrid Closed-Loop System in Adolescents with Type 1 Diabetes over Five Days Under Free-Living Conditions

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 1376-P
Author(s):  
GREGORY P. FORLENZA ◽  
BRUCE BUCKINGHAM ◽  
JENNIFER SHERR ◽  
THOMAS A. PEYSER ◽  
JOON BOK LEE ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Closed Loop ◽  
Living Conditions ◽  
Loop System ◽  
Closed Loop System ◽  
Free Living ◽  
And Performance ◽  
Free Living Conditions
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