What Does The System Do
When you build the system, all of which is free to download with instructions available online, you will see that the DIY loop system immediately starts reading your blood sugars off of your CGM, and transmits that data to an app on your phone .
The system makes adjustments automatically , but it doesnt account for food eaten.
You still need to bolus like normal for carbohydrates, hence the hybrid closed-loop system. There is currently no completely closed-loop system that would essentially use artificial intelligence to predict food or exercise.
Studies have shown that DIY APS systems improve not only time-in-range for people with diabetes, but also vastly improve quality of life.
In a 2016 self-reported outcomes study, 56% of DIY loop users reported a large improvement in sleep quality.
A type 1 parent, Dr. Jason Wittmer, tracked his sons school nurse visits: before OpenAPS, his 4th-grade son averaged 2.3 visits per day after OpenAPS, his son visited the school nurse 5 times during the entire school year.
Families using DIY loop systems also report less time spent talking about diabetes and improved family communication around diabetes.
They also report improved sleep quality for multiple family members and spending less time thinking about diabetes and doing diabetes-related management tasks, such as treating lows or sitting out of sports due to highs.
Diy Looping: Building Your Own Closed Loop System
If you live with diabetes, you may have heard of the term DIY Looping but may not have any idea what it actually is.
DIY Looping is the process by which someone with diabetes hacks their existing insulin pump with a single-board computer, such as a RileyLink or Raspberry Pi.
This essentially makes your insulin pump communicate with a continuous glucose monitor to make basal insulin adjustments automatically, instead of manually suspending, reducing, or increasing insulin throughout the day.
This is a popular and growing movement and has helped countless people improve not only their blood sugars but their emotional and mental health as well.
In this article, you will learn what DIY looping is, how it works, the pros and cons, and lessons learned from a year of looping myself.
The History Of A Wonderful Thing We Call Insulin
Since the dawn of time, we have searched for ways to make life easier for us. The modern age has given us some amazing technological advanceswhat we would do without the internet, our iPhones or high-speed travel?
For many people, surviving life without these things sounds rough. However, if you have diabetes, no doubt youre also a big fan of one particular 20th-century discovery: insulin.
Before insulin was discovered in 1921, people with diabetes didnt live for long there wasnt much doctors could do for them. The most effective treatment was to put patients with diabetes on very strict diets with minimal carbohydrate intake. This could buy patients a few extra years but couldnt save them. Harsh diets sometimes even caused patients to die of starvation.
So how did this wonderful breakthrough blossom? Lets travel back a little more than 100 years ago.
In 1889, two German researchers, Oskar Minkowski and Joseph von Mering, found that when the pancreas gland was removed from dogs, the animals developed symptoms of diabetes and died soon afterward. This led to the idea that the pancreas was the site where pancreatic substances were produced.
Later experimenters narrowed this search to the islets of Langerhans . In 1910, Sir Edward Albert Sharpey-Shafer suggested only one chemical was missing from the pancreas in people with diabetes. He decided to call this chemical insulin, which comes for the Latin word insula, meaning island.
Last reviewed: August 31, 2020
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Eat More Soluble Fiber
Fiber can be divided into two broad categories soluble and insoluble.
Insoluble fiber mostly acts as a bulking agent to help stool move through the bowels.
Meanwhile, soluble fiber is responsible for many of fibers associated benefits, like lowering cholesterol and reducing appetite (
33 ).
For example, a study involving 264 women found that those who ate more soluble fiber had significantly lower levels of insulin resistance .
Soluble fiber also helps feed the friendly bacteria in your gut, which have been linked to increased insulin sensitivity .
Foods that are rich in soluble fiber include legumes, oatmeal, flaxseeds, vegetables like Brussels sprouts and fruits like oranges.
Summary
Eating soluble fiber has many health benefits and has been linked to increased insulin sensitivity. It also helps feed the friendly bacteria in your gut.
October 1923 Insulin Produced On A Mass Scale
As news of insulins success spread, demand rocketed. The researchers set about improving their techniques for the production of insulin so it could be made in much larger quantities. Eli Lilly become the first manufacturer to mass produce insulin and in October 1923 they began shipping the first commercial supply of insulin.
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Frugal Diabetics Are Making Their Own Insulin
Biohackers are counteracting soaring insulin prices by concocting a do-it-yourself version on the cheap.
The healthcare industry has been using insulin to treat diabetes since 1922, and until the 80s, the protein was extracted from the pancreas of pigs or cows. Now, pharmaceutical companies can create unlimited biosynthetic human insulin via genetically engineered cells, but the World Health Organization says many diabetics dont have access to the drug, which could result in blindness, amputations, kidney failure, and early death.
Skyrocketing insulin prices has forced some patients with diabetes to ration the drug thats vital to their survival. According to a recent DWarticle, biohackers have devised a way to produce insulin cheaper, and it seems to be catching on. The team behind the project is based in Oakland, California and under the name Open Insulin Project. Their goal is simple: establish a protocol for do-it-yourself insulin that provides adventurous and frugal patients with diabetes information on producing small batches of insulin.
Type I Diabetes And Making Insulin
One of the questions I am asked most often is how to deal with Type 1 diabetics in a long-term survival scenario. There is a story about how home-made Insulin was produced in Japanese-occupied Singapore during WWII. I have been unable to find the specific process used there, but I have come upon a lecture by one of the scientists who first produced Insulin in the lab. This occurred in 1922, and the lecture is from that era. The material used was the pancreatic organs of cows and pigs. I will add some comments below the transcript of the lecture.
Here it is:
The present method of preparation is as follows. The beef or pork pancreas is finely minced in a larger grinder and the minced material is then treated with 5 c.c. of concentrated sulphuric acid, appropriately diluted, per pound of glands. The mixture is stirred for a period of three or four hours and 95% alcohol is added until the concentration of alcohol is 60% to 70%. Two extractions of the glands are made. The solid material is then partially removed by centrifuging the mixture and the solution is further clarified by filtering through paper. The filtrate is practically neutralized with Sodium Hydroxide. The clear filtrate is concentrated in vacuo to about 1/15 of its original volume.
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What Are The Signs & Symptoms Of Type 2 Diabetes
Many people with insulin resistance have dark patches on their skin, especially in skin folds like those around the neck or in the armpits. This is called acanthosis nigricans, or simply acanthosis, and its often an early sign that a person may develop type 2 diabetes.
Type 2 diabetes can show up in different ways. Some people have symptoms, but others dont. Someone with diabetes symptoms may:
- need to pee a lot
- be thirstier and drink more than usual
- feel tired often
- have blurry vision
What’s It Like For Teens With Type 2 Diabetes
Sometimes people who have diabetes feel different from their friends because they need to think about how they eat and how to control their blood sugar levels every day.
Some teens with diabetes want to deny that they even have it. They might hope that if they ignore diabetes, it will just go away. They may feel angry, depressed, or helpless, or think that their parents are constantly worrying about their diabetes management.
If you’ve been diagnosed with type 2 diabetes, it’s normal to feel like your world has been turned upside down. Your diabetes care team is there to provide answers and support. Don’t hesitate to ask your doctors, dietitian, and other treatment professionals for advice and tips. It also can help to find support groups where you can talk about your feelings and find out how other teens cope.
Diabetes brings challenges, but teens who have it play sports, travel, date, go to school, and work just like their friends.
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Foods To Boost Natural Insulin
Your pancreas releases insulin in response to rising blood glucose levels, such as when you eat a meal. But increased amounts of natural insulin may be released if you consume certain dietary nutrients. Research indicates that diets rich in protein and healthy fat may help improve insulin levels in people living with diabetes.
Through digestion, the proteins you eat are broken down into amino acids, which play many crucial roles inside your body. Some amino acids, including those that come from protein, trigger pancreatic cells to produce and release more insulin. While its good to eat proteins from a variety of sources, some research indicates that plant-based proteins are especially beneficial for increasing natural insulin levels. Plant-based proteins come from a variety of sources, including beans, lentils, peas, nuts, and tofu.
Healthy fats also help your pancreas release insulin naturally. While the process is not fully understood, research shows fats increase the likelihood that insulin is released when blood sugar levels rise. Healthy fats are found in many dietary sources, including:
A Small Study So More Research Is Needed
Its important to remember that the study only used cells from three people, so much larger projects are needed to confirm their results. But Professor El-Osta, said: The discovery of the genetic barrier to insulin which can be unlocked by a drug is an important milestone and a step in the right direction for the path to accelerate cures.
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How Do You Build Your Own System
This part gets complicated but is doable even for a novice. The OpenAPS community firmly believes in keeping OpenAPS open source, for all to use.
The beauty of this community is everyones willingness to help one another to achieve better health outcomes. The community has created and maintains the online instructions to build your own system at a website called LoopDocs with a thorough explanation of the process and FAQ.
To get started, though, this is what youll need to build your own DIY loop:
- Standard basal rates for different times of day
- Insulin to carbohydrate ratio
Once you finish installing Xcode and building the Loop app, you can either opt for an open loop mode or closed loop mode.
This is the RileyLink single board computer in its enclosure. This must be near you and your iPhone at all times to make dosing decisions and bolus. The RileyLink acts as a bridge allowing your insulin pump to communicate with your iPhone, where the Loop app is running.
The open-loop mode merely gives you suggestions for dosing but doesnt actually override your regular basal insulin pump program, whereas if you close the loop the new settings on your Loop app will override your old basal program.
Its important to remember that your RileyLink hardware needs to be in close proximity to your iPhone at all times. Your iPhone now serves as your new insulin pump and all dosing decisions are made from the app on your phone.
Why Do Some People Get Type 2 Diabetes
No one knows for sure why some people get type 2 diabetes, but its likely a combination of genes and the environment. Many teens who get it have someone in their family who has it too.
Type 2 diabetes happens more often in people:
- who are overweight. When a person has extra weight, sugar in the blood doesnt get into the cells as well as it should. But people dont have to be overweight to get type 2 diabetes.
- during puberty. Many kids and teens are diagnosed with type 2 diabetes around puberty. As growth hormone levels normally rise during puberty, insulin does not work as well.
- with polycystic ovary syndrome . Girls and women with PCOS have insulin resistance and are more likely to get type 2 diabetes.
- whose mothers had diabetes during pregnancy. Babies are exposed to more sugar in the womb when their mother has diabetes. This along with genetic factors increase the chance of getting type 2 diabetes later in life.
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November 1920 Great Minds Come Together
In October 1920, Frederick Banting a Canadian surgeon read an article that suggested insulin-producing cells in the pancreas are slower to deteriorate than other pancreas tissue. Banting realised that this might allow for the removal of insulin by breaking down the pancreas in a way that would leave just the cells that produce insulin intact.
But Banting wasnt a scientist and knew he couldnt test his theory alone. On 7 November 1920 he paid a visit to a top professor at the University of Toronto, John Macleod. They put their minds together and began to work on a plan.
Can You Stockpile Insulin
Stockpiling insulin might be difficult unless you begin early. Keeping your insulin cool could be problematic, depending on the climate, but there are nice cool caves most places, so you could stash the precious stuff underground.
Who owns patent on insulin?
Based on the filing date and a 20 year patent period, patents on analogue insulins already on the market in the US and Canada have expired or will soon expire in these countries and elsewhere . Four companies, Eli Lilly, Sanofi, Novo Nordisk, and Pfizer, own these patents.
How much does a 30 day supply of insulin cost?
Before that, the insurance behemoth Cigna, and its pharmacy benefit arm Express Scripts, announced a program thatll cap the 30-day cost of insulin at $25. Thats a 40 percent reduction from the $41.50-per-month fee people with Express Scripts benefits were paying in 2018.
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What Exactly Is Insulin
Is insulin a protein or a hormone?
In case you didnt know, insulin is a hormone thats produced by the pancreas. In people who have diabetes, the pancreas has become damaged and therefore cannot properly produce this vital substance that the body needs.
Insulin is responsible for how the body processes sugar. The bodys cells need to have sugar for energy but this sugar cant enter them directly.
So, after you eat food and your blood sugar increases, cells in the pancreas release insulin into the bloodstream. This hormone attaches itself to cells and tells them to absorb sugar from the blood. But it also has some other interesting functions.
If your body has more sugar than your cells need, insulin will store the excess sugar in the liver. If your blood sugar becomes low, these reserves will be released. In this way, insulin helps to balance your blood sugar so that theyre within a normal range.
If you have diabetes, it basically means that your bodys not releasing the insulin that it needs. This results in cells of the body being starved for energy and seeking it from different sources, which can lead to life-threatening complications.
How Did This Come About
This movement stemmed from the frustration and disappointment people with diabetes have felt for a long time at the pace that technology was being developed.
Looping is the brainchild of many brilliant people and families affected by diabetes who started the #WeAreNotWaiting movement nearly a decade ago.
The hashtag was coined in 2013 at the first-ever DiabetesMine D-Data ExChange gathering at Stanford University by Lane Desborough and Howard Look .
Looping is part of the larger Open Artificial Pancreas System movement where advocates in the diabetes community are developing opensource platforms, code, and apps to essentially reserve-engineer existing durable medical equipment to help people living with diabetes achieve better health outcomes when FDA-approved devices have proven inadequate.
Dana Lewis and Scott Leibrand of Seattle, Washington, were the first couple to develop the OpenAPS, a homemade artificial pancreas, for her own diabetes management.
It is now being used by thousands of people around the world, and many more developers have added onto and built upon the original code, improving the system with each software update. Nate Racklyeft has written a great piece on the history of Loop.
In 2014, diabetes advocate, Anna McCollister-Slipp, told Forbes:
The OpenAPS community wanted to change that.
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What Problems Can Happen With Type 2 Diabetes
Not having the right amount of sugar in the blood can lead to:
- hyperglycemia.This is when blood sugars are too high. Someone with hyperglycemia may be extra thirsty and pee more than usual. If high blood sugars arent treated, they can get very sick and have health issues later in life, like heart and kidney problems.
- diabetic ketoacidosis . This serious condition needs treatment right away. When theres not enough insulin in the body to let the glucose into the cells, the body starts to break down fat instead of sugar. Symptoms of DKA can include nausea, vomiting, belly pain, fast breathing, and in severe cases, unconsciousness. DKA happens more often in people with type 1 diabetes, but it can sometimes happen to those with type 2 diabetes.
- hyperglycemic hyperosmolar state . Like DKA, this is a serious condition that needs treatment right away. People with HHS have severe dehydration and very high blood sugars.
- hypoglycemia. This is when blood sugars are too low. It can sometimes happen when people with type 2 diabetes are treated with insulin. If a person with diabetes gets more insulin than they need, their blood sugar level can drop too low. Symptoms can include headache, weakness, shakiness, anxiety, and sweating.