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Hacking Diabetes Hack Chat

Diabetes met a hacker. Diabetes lost.

Wednesday, October 16, 2019 12:00 pm PDT Local time zone:
Hack Chat
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Dana Lewis joins us for the Hack Chat on Wednesday, October 16, 2019 at noon PDT.

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When your child is newly diagnosed with Type 1 diabetes (T1D), everyone is quick to point out, "It's a great time to be a diabetic." To some degree, that's true; thanks to genetically engineered insulin, more frequent or even continuous glucose monitoring (CGM), and insulin infusion pumps, diabetics can now avoid many of the truly terrifying complications of a life lived with chronically elevated blood glucose, like heart disease, kidney failure, blindness, and amputations.

Despite these advances, managing T1D can be an overwhelming task. Every bite of food, every minute of exercise, and every metabolic challenge has to be factored into the calculations for how much insulin to take. Diabetics learn to "think like a pancreas," but it's never good enough, and the long-promised day of a true artificial pancreas always seems to remain five years in the future.

Dana Lewis is one diabetic who decided not to wait. After realizing that she could get data from her CGM, she built a system to allow friends and family to monitor her blood glucose readings remotely. With the addition of a Raspberry Pi and some predictive algorithms, she later built an open-source artificial pancreas, which she uses every day. And now she's helping others take control of their diabetes and build their own devices through OpenAPS.org.

Join us on the Hack Chat as Dana drops by to discuss OpenAPS and her artificial pancreas. We'll find out what her background is - spoiler alert: she wasn't a hacker when she started this - what challenges she faced, the state of the OpenAPS project, and where she sees the artificial pancreas going.

[Dana Lewis image source: GeekWire]

  • Hack Chat Transcript, Part 3

    Dan Maloney6 days ago 0 comments

    Colin McCrory12:49 PM
    I'm not looping at the moment because the only pump I can get right now is the 640G I've just been using it as a CGM. I think I'll give dexcom a try

    c448108012:50 PM
    @Colin McCrory I'm gonna try doing an open loop with 640G

    Dana Lewis12:50 PM
    @Colin McCrory not sure if you saw from earlier in the chat, but if you are up for carrying extra stuff, you could start with using 640 as a CGM uploader and wear a loopable pump to start looping, while you explore getting another CGM.

    Andrea R.12:50 PM
    @Dana Lewis I have back ups for my back ups.

    Dana Lewis12:50 PM
    (requires internet connectivity though)

    Dana Lewis12:50 PM
    @Andrea R. :D sounds about right!

    c448108012:51 PM
    Has there been any attemps to jailbreak / dump the firmware of the commerical devices ?

    F5OEO12:51 PM
    @Dana Lewis , even you don't use omnipod, I think that it coud be a huge signal as a leader to test it..unfrotunatelly, this kind of experience is always problematic when it deals with your health and your current system is working well ;)

    Scott Leibrand12:51 PM
    @c4481080 That was what they had to do to crack the OmniPod.

    Andrea Limbourg12:52 PM
    @F5OEO If you haven't already join the Android APS (toutes pompes) and Looped France groups on FB. They are becoming more and more active. And we had a Loop meet up in Paris last week. There will definitely be more!

    Colin McCrory12:52 PM
    I think I'll have more luck getting a dexcom than I will getting a loopable pump. Buying a dexcom out of pocket in the UK is easy but as far as I know my local health authority only use the 640g and I cant buy a Dana r unless prescribed by them

    Dana Lewis12:52 PM
    I'm not sure any extra signal is needed there, lots of folks using it these days.

    Dana Lewis12:53 PM
    @Andrea Limbourg that's awesome to hear!

    F5OEO12:53 PM
    Oh , I need to join it, thanks ...

    Jon Cluck12:53 PM
    If folks are looking for general peer support stuff about T1D, we have a Discord server here (no dev work gets done here tho): https://discord.gg/diabetes

    Andrea Limbourg12:54 PM
    @Dana Hopefully we can do a build party at some point, but this first meet up was super casual to get to know one another. Nice to be with other loopers though and be able to answer some questions for those who are curious!

    Andrea R.12:55 PM
    @Andrea Limbourg agreed!

    F5OEO12:55 PM
    Just for my experience, I never meet such high skill people in openomni project...and the result is there !

    Kyle J. Rose12:56 PM
    Thank you @Andrea Limbourg for what you are doing helping further bring together this community in France!

    Andrea Limbourg12:58 PM
    @Kyle J. Rose I'm super happy to be involved. I have gained so much from this community and I feel like I can only give a little but I'll give what I can.

    c448108012:58 PM
    I'm trying to do my own DIY hacking currently

    c448108012:59 PM
    non APS related though, Smart Home...

    One last question, because no discussion is complete without mentioning machine learning anymore: anyone working on AI closed loop systems? Using Tensor flow to analyze CGM patterns, etc?

    F5OEO1:00 PM
    Good question...

    Jon Cluck1:00 PM
    Yeah, marius eriksen (@marius on twitter) has some stuff about working with that

    Franziska1:01 PM
    @Dan Maloney Hopefully I can start in the next year with it ... anybody else working on it?

    Dana Lewis1:01 PM
    lots of people who are working on AI/ML...nothing coming to practical real-world use at large scale yet, though. Marius ^ is probably doing the most that I've seen to date.

    Dana Lewis1:01 PM

    https://twitter.com/marius/status/1022193035956826112?lang=en

    TWITTER MARIUS

    marius eriksen on Twitter

    I chatted with @petewarden about how I use Tensorflow to implement model predictive control of glucose levels in my daughter's closed-loop insulin delivery system. (See also: https://t.co/Lo9zmPuKp3) https://t.co/nmtW8piu3U

    Read this on Twitter

    Cool, thanks!

    Franziska1:01 PM
    @Dana Lewis Thanks!

    Well folks, that's an hour, so we have to let Dana get back to work if...

    Read more »

  • Hack Chat Transcript, Part 2

    Dan Maloney6 days ago 0 comments

    Dana Lewis12:21 PM
    hey @Kyle J. Rose! that's a good question. I think there are a couple of advocacy pushes that would be useful: to insurance companies to cover CGM (not to mention insulin) and eventually APS; for us individual advocates to the companies to make the APS coming out more transparent and understandable, etc.

    Irene C. S.12:21 PM
    @c4481080 I'd like to build it as a wristband, but maybe in the future hahaha it has to work first!

    c448108012:21 PM
    I recall seeing every now and then that apple tried to do that with the Apple Watch

    Dana Lewis12:21 PM
    I also think encouraging individuals to continue to share their experiences (and data) with DIY and commercial APS is helpful, for educating our community and also showing what the companies need to do better to roll out commercial tech.

    Hochkbry12:22 PM
    hi yall, I figured I'd drop in. I'm a currently a college student in the process of getting a pump. @Dana Lewis I think the work you do is amazing.

    Dana Lewis12:22 PM
    speaking of data donation - if you're using a DIYAPS of any kind, please consider donating data to the OpenAPS Data Commons (https://openaps.org/data-commons/) so it can be used for various research & development projects :)

    @Dana Lewis - Do you know of any commercial APS systems in the works? Wondering if anyone is really trying to close the loop on the low side with emergency glucagon infusion.

    Dana Lewis12:22 PM
    @Hochkbry welcome! thanks for dropping in.

    Bill Staffeldt12:23 PM
    I don't know much about the status of DIY loop mechanisms out there. Would you recommend people who are not very tech savvy to go down this road? My daughter has T1 (8 years old) and even as a developer for 10+ years I'm hesitant to do something like that with her right now. If it were me, I'd already be doing it.

    Dana Lewis12:23 PM
    DiaTribe has a pretty comprehensive list of the commercial systems: https://diatribe.org/automated-insulin-delivery

    Kyle J. Rose12:23 PM
    @Scott Leibrand Thinking more on the Policy advocacy and and community support sides. @Dana Lewis Okay, that's helpful. I often receive questions and direct people to existing online groups and documentation. But always wonder if there is more I could do or if there are specific community needs could help address.

    Dana Lewis12:23 PM
    @Bill Staffeldt knowledge of your own diabetes is the most important. Many people with zero technical background successfully DIY loop with each of the systems.

    Dana Lewis12:24 PM
    there are kids as young as 1yo who have had their parents build their DIY systems. obviously, depending on the age of the child and their current role in diabetes care, they may play a bigger or smaller role in the decision making process in deciding whether or not a DIYAPS makes sense for them

    Andrea Limbourg12:25 PM
    @Bill Staffeldt Interesting. I would be the opposite. I waited to use a DIY system until I had access to a pump easily. If it was my kid, I would have bought an out of warranty Medtronic a couple of years ago.

    @Bill Staffeldt - Same here, my daughter's onset was when she was 8 five years ago. I haven't done much more than keep my head above water in that time, despite being a pretty fair hacker. It really boils down to not having the time because I need to stay employed so I can afford to keep her in insulin.

    Dana Lewis12:26 PM
    There are a lot of resources to read more if you want to evaluate and figure out if it's right for you/your family. One resource: I wrote a book to be a general intro to DIY & commercial APS, it's available free online or as a PDF download (or you can buy a print/kindle copy) if you're interested in more: https://www.artificialpancreasbook.com/ (and links to each of the DIY systems in various places)

    Andrea R.12:26 PM
    @Kyle J. Rose one issue I've run into as a patient is fear that my endo would "fire" me for using Loop. I was really hesitant to share with her what I was doing and she was ultimately somewhat supportive (with the caveat that she can't recommend...

    Read more »

  • Hack Chat Transcript, Part 1

    Dan Maloney6 days ago 0 comments

    c448108011:48 AM
    It's so annoying that you can't use the new medatronic pumps with closed loop projects :(

    spaceneedle joined  the room.11:49 AM

    IKR? I've got an old Animas pump sitting around doing nothing that I'd love to put to work

    Casey Halverson11:51 AM
    Hello

    Hi, welcome!

    Dana Lewis11:51 AM
    hey @Casey Halverson!

    Scott Leibrand11:51 AM
    @c4481080 it is possible to use the 640G/670G as a CGM to upload to Nightscout and power a closed loop, but I agree it's a bummer that those aren't interoperable for insulin dosing.

    Casey Halverson11:52 AM
    hi @Dana Lewis ! Great to join you guys! I saw this cross my email just now. Perfect timing!

    Dana Lewis11:52 AM
    :)

    Pedrozamora11:53 AM
    Dynamite

    c448108011:53 AM
    I've tried using the android app, with the 640G but it did ntot work

    Scott Leibrand11:53 AM
    Medtronic did announce they'll be making an interoperable ACE (alternate controller enabled) pump for projects like Tidepool Loop once they get FDA approval as an iController, but who knows what the timing will be on that.

    c448108011:54 AM
    @Scott Leibrand Do you have experience with that ? https://github.com/pazaan/600SeriesAndroidUploader/wiki did not work for me, and I couldnt figure out why

    Scott Leibrand11:55 AM
    No, I know it's possible, and that it requires a Contour NextLink meter connected via USB to an Android phone, but I've never tried it myself.

    c448108011:55 AM
    Yeah, I connected it, but nothing happened (it was OTA)

    c448108011:55 AM
    I'm waiting for approval of the 670G here at the end of the year

    Dana Lewis11:55 AM
    there's a good gitter channel that might be worth joining to troubleshoot specifics: https://gitter.im/pazaan/decoding-contour-next-link

    Scott Leibrand11:55 AM
    There are some good support channels linked in the docs if you want to get assistance to make it work.

    Scott Leibrand11:55 AM
    ^^ that :)

    Sean Hodgins joined  the room.11:56 AM

    c448108011:56 AM
    Thanks, I'll take a look into that (altough we are more of an iOS family :) )

    mrb0t. joined  the room.11:56 AM

    Andrea R. joined  the room.11:56 AM

    Dana Lewis11:56 AM
    us, too - although back in the day :) it was worth it to carry the extra Android phone as the original uploader to get CGM data into the cloud on the go!

    c448108011:57 AM
    Might be nice to publish this chat mabe in those glitter as well

    Baruch Even joined  the room.11:59 AM

    OK, let's get started. I want to welcome Dana Lewis to the Hack Chat today. Dana built her own artificial pancreas, which is about as awesome as it gets. We're going to talk all about that and hacking diabetes in general.

    Welcome Dana! Can you start us off with a little about yourself?

    irene.carrasco.shwartz joined  the room.12:00 PM

    c448108012:00 PM
    BTW "@c4481080 it is possible to use the 640G/670G as a CGM to upload to Nightscout and power a closed loop, but I agree it's a bummer that those aren't interoperable for insulin dosing." <-- power a closed loop, so you mean use 640G, and another pump ?

    Dana Lewis12:01 PM
    Sure thing. Hi everyone! I’m Dana Lewis, one of the people who created the open-source ‘artificial pancreas’ system, or closed-loop system. I’ve had type 1 diabetes for 17 years as of Monday, and although I’m not a developer or programmer by day job, I’ve spent the last ~6 years or so working to gain access to data from various diabetes devices; putting it together in algorithms to help me make better decisions, or even automate away a lot of the work I have to do. Looking forward to the chat today! Note you’ll see other OpenAPS/DIY co-developers like @Scott Leibrand @Jon Cluck, etc joining today as well - plus awesome open-source hardware partners like @Casey Halverson as well.

    Kyle J. Rose joined  the room.12:01 PM

    art joined  the room.12:01 PM

    Franziska joined  the room.12:02 PM

    Scott Leibrand12:02 PM
    @c4481080 yes, you can use the 640G/670G as an oversized CGM receiver, and then another pump for actually dosing insulin. It probably makes more...

    Read more »

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