10 ms·

As a type 1 diabetic I'm super excited to see apple working in this space, even if they're focusing it on type 2 to start (a logical move, considering there is

As a type 1 diabetic I'm super excited to see apple working in this space, even if they're focusing it on type 2 to start (a logical move, considering there is something like 30x more type 2 diabetics in the US). I think making it easier to track glucose levels in real time is the number one thing that can be done to improve quality of life for both types of diabetics. The "CGM" (continuous glucose monitor) has really come into it's own over the last 10 or so years, and I would encourage all diabetics (but especially type 1) to use one. Currently the only 2 real options on the market are: - http://www.dexcom.com/ http://www.dexcom.com/ - Connects directly to your phone using bluetooth and will send glucose warnings etc as notifications. - https://www.medtronicdiabetes.com/products/enlite-sensor https://www.medtronicdiabetes.com/products/enlite-sensor - Designed to work with Medtronic (who is a market leader) insulin pumps. Both these options are expensive (even with insurance for many), invasive, and not really tailored towards "casual" glucose monitoring. I think if Apple enters the space with a non-invasive tool it'll be a huge boon for causal glucose monitoring. I also think it could be a more accessible option for people who are interested using a CGM to treat their diabetes but can't/won't use one of the existing options due to cost or inconvenience. This seems like a win win and I'm excited to see where it goes.

pimeys 9y ago
Here in Germany the Dexcom G4 system with Animas Vibe insulin pump became fully covered by the health insurance last November and a couple of weeks ago I got my system working. It is a pretty amazing improvement to my life: both the pump and CGM. The G4 transmitter has a 2.4 GHz radio and I built an extra device with Wixel and Bluetooth to transfer the data so my Android phone so xDrip+ and my Android watch can display the glucose values real time. It works so great that my A1c levels been going down from over 7% to 5-6%. If you are in Europe and have a Type 1 Diabetes, you should ask your doctor about your options.
- templaedhel 9y ago
  If you have an insulin pump (best if it's an older one, since newer ones are harder to hack) you should look into OpenAPS (open artificial pancreas system) https://openaps.org/ https://openaps.org/. People have code/schematics available to build a closed loop system between CGM<>insulin pump which automatically adjusts the dosage based on glucose levels and keeps you in range better than even the best attempts at manual dosages. Seems like you've already done half the work, which is connecting the CGM to a device you can run custom code on. Medtronic just came out with their first closed loop system (https://www.medtronicdiabetes.com/products/minimed-670g-insulin-pump-system https://www.medtronicdiabetes.com/products/minimed-670g-insu...), but OpenAPS has been around for years, and not sure how Medtronic will go about getting the 670 approved in Germany.
  - pimeys 9y ago
    The Medtronic 670g was my other option, but I took the Animas Vibe + Dexcom G4 just because it's easier to hack, lots of German Diabetes hackers use it, its CGM seems to be more accurate and you can use the G4 sensors way longer than the 670g. 670g is a closed loop system, but what it does is it stops giving you the basal insulin when it thinks you are getting a hypoglycemia soon. What it doesn't do is to give you correct amount of insulin automatically when you've been eating carbs or doing exercise to keep your glucose level in the 5.5 mmol/l target. And with the new Fiasp insulin automatic adjustments would be possible. To be able to build the OpenAPS, you must have an older Medtronic pump which are not covered by German insurance anymore. My Animas doesn't allow to tweak the insulins remotely.
    - cperciva 9y ago
      The 670G completely controls basal rates; the "suspend on low" functionality arrived in a previous generation. But it won't keep your blood glucose at 5.5 mM -- it targets 6.7 mM, and there doesn't seem to be any way to change this. :-/
      - pimeys 9y ago
        Sounds nice. I still think I'm going to manage my insulins manually until the next generation of artificial pancreas. This system what I have is already the biggest ever improvement for my diabetes I've ever had.
  - dingo_bat 9y ago
    Isn't it a bit scary to run the auto-insulin code on an android phone?
    - wapz 9y ago
      I do not have an insulin pump and I'm presuming you don't with my response. The pumps I have seen make noise when they are pumping and also have an alarm (I'm not sure if that's from the pump or the reader) if your levels are on either extreme. I'm guessing malfunctioning code would only execute once by pumping too much or not pumping at all and the user would figure it out very quickly.
- richie5um 9y ago
  Unfortunately I can't get this in the UK. I asked, but they only give out to kids or people who poorly manage their T1. :(
  - spullara 9y ago
    Can you pay for it yourself with their discount?
  - ollysb 9y ago
    There's https://www.freestylelibre.co.uk/libre/ https://www.freestylelibre.co.uk/libre/ which I believe you can just order online (I'm considering one myself). You have to scan the sensor yourself(it stores the data between scans) so it doesn't trigger alarms like the dexcom but for gathering data about how exercise/diet effects your levels it should do the job nicely I think. edit: The starter pack costs £159.95, see https://www.freestylelibre.co.uk/libre/products/starter-pack.html https://www.freestylelibre.co.uk/libre/products/starter-pack...
    - thesehands 9y ago
      The sensors are quite pricey to get, each lasting roughly 2 weeks. Unfortunately the sensors aren't available on prescription yet. Let's hope this changes.
    - cyunem 9y ago
      These were recently included in the coverage given by the danish government (at least in my area) and this is probably the biggest quality of life improvement I have received in at least 10 years of diabetes. Even though it's not as clever as some of the other systems, being able to get an idea of the level without having to find a secluded spot and prick my finger is a really great feeling. It also means I can actually check my levels while at a party for example, where previously I would put it off for a bit because it was inconvenient.
    - pimeys 9y ago
      German insurance companies cover these too and I had them about six months before switching to Dexcom system. The NFC scanner provided is not accurate at all. The values are what they are and you can't calibrate them. Luckily if you own an Android phone with NFC reader you can use xDrip+ to scan the values and xDrip+ allows calibrations, so the measurements reflect your blood sugar much more accurately. I'm having trouble with not feeling hypoglycemias and I'm having them quite often at night. Freestyle Libre by default doesn't automatically measure your glucose levels, but there is a hack with Sony Smartwatch 3, a strap and very custom and hacky android version which enables the NFC reader in Sony and you can get alarms to your phone on low glucose levels. It worked and saved me a couple of nights, but the Libre chips break easily and the system was kind of a drag to use in the end.
- ferongr 9y ago
  Europe is not a country. I'd wager less prosperous countries do not cover such devices.
acoster 9y ago
My partner is type 1 diabetic, and CGMs were a game changer for her (they started rolling out in Switzerland last year). She's been using the FreeStyle Libre (https://www.freestylelibre.co.uk/libre/ https://www.freestylelibre.co.uk/libre/), which uses NFC and on select markets has an Android app available, but here we still have to use the handheld reader.
- CositaS 9y ago
  I find the non-official Android Libre reader app 'Glimp' useful. Even though I have the official one, I keep both installed, because Glimp does less smoothing/extrapolation of the readings.
- pimeys 9y ago
  I seriously recommend testing xDrip+ with the Libre. Better results and you don't need to carry an extra reader device with you all the time: https://github.com/NightscoutFoundation/xDrip https://github.com/NightscoutFoundation/xDrip Pull requests are welcome too :)
  - dale-cooper 9y ago
    In what way does it offer better results? There's an official android app for libre too, i'm not sure if it's available everywhere though.
    - pimeys 9y ago
      The libre measures the glucose from the interstitial fluid, which doesn't map directly to the value measured from blood. Think about coordinates, where X is the value from interstitial fluid and Y is the value from blood. You must draw a line somewhere to map the values correctly and the Libre is calibrated in the factory. For me the Libre reader was just an ok indicator about the trend, but the actual value was sometimes not even near the value shown. It's ok between the normal range 4.0-8.5 mmol/l, but I'd be suspicious about every value outside of that range. With xDrip you can input values measured from blood and the software will try to estimate as accurate values as possible, meaning that in the best case you can be quite sure about the reading, but always better to check from blood. Remember, that calibration should happen only when the levels are steady and you should calibrate from the whole range to trust the readings. Anyways at least 2-3 measurements per day from blood is suggested, even with the more expensive CGM's.

pimeys 9y ago

Here in Germany the Dexcom G4 system with Animas Vibe insulin pump became fully covered by the health insurance last November and a couple of weeks ago I got my system working. It is a pretty amazing improvement to my life: both the pump and CGM. The G4 transmitter has a 2.4 GHz radio and I built an extra device with Wixel and Bluetooth to transfer the data so my Android phone so xDrip+ and my Android watch can display the glucose values real time. It works so great that my A1c levels been going down from over 7% to 5-6%. If you are in Europe and have a Type 1 Diabetes, you should ask your doctor about your options.

templaedhel 9y ago
If you have an insulin pump (best if it's an older one, since newer ones are harder to hack) you should look into OpenAPS (open artificial pancreas system) https://openaps.org/ https://openaps.org/. People have code/schematics available to build a closed loop system between CGM<>insulin pump which automatically adjusts the dosage based on glucose levels and keeps you in range better than even the best attempts at manual dosages. Seems like you've already done half the work, which is connecting the CGM to a device you can run custom code on. Medtronic just came out with their first closed loop system (https://www.medtronicdiabetes.com/products/minimed-670g-insulin-pump-system https://www.medtronicdiabetes.com/products/minimed-670g-insu...), but OpenAPS has been around for years, and not sure how Medtronic will go about getting the 670 approved in Germany.
- pimeys 9y ago
  The Medtronic 670g was my other option, but I took the Animas Vibe + Dexcom G4 just because it's easier to hack, lots of German Diabetes hackers use it, its CGM seems to be more accurate and you can use the G4 sensors way longer than the 670g. 670g is a closed loop system, but what it does is it stops giving you the basal insulin when it thinks you are getting a hypoglycemia soon. What it doesn't do is to give you correct amount of insulin automatically when you've been eating carbs or doing exercise to keep your glucose level in the 5.5 mmol/l target. And with the new Fiasp insulin automatic adjustments would be possible. To be able to build the OpenAPS, you must have an older Medtronic pump which are not covered by German insurance anymore. My Animas doesn't allow to tweak the insulins remotely.
  - cperciva 9y ago
    The 670G completely controls basal rates; the "suspend on low" functionality arrived in a previous generation. But it won't keep your blood glucose at 5.5 mM -- it targets 6.7 mM, and there doesn't seem to be any way to change this. :-/
    - pimeys 9y ago
      Sounds nice. I still think I'm going to manage my insulins manually until the next generation of artificial pancreas. This system what I have is already the biggest ever improvement for my diabetes I've ever had.
- dingo_bat 9y ago
  Isn't it a bit scary to run the auto-insulin code on an android phone?
  - wapz 9y ago
    I do not have an insulin pump and I'm presuming you don't with my response. The pumps I have seen make noise when they are pumping and also have an alarm (I'm not sure if that's from the pump or the reader) if your levels are on either extreme. I'm guessing malfunctioning code would only execute once by pumping too much or not pumping at all and the user would figure it out very quickly.
richie5um 9y ago
Unfortunately I can't get this in the UK. I asked, but they only give out to kids or people who poorly manage their T1. :(
- spullara 9y ago
  Can you pay for it yourself with their discount?
- ollysb 9y ago
  There's https://www.freestylelibre.co.uk/libre/ https://www.freestylelibre.co.uk/libre/ which I believe you can just order online (I'm considering one myself). You have to scan the sensor yourself(it stores the data between scans) so it doesn't trigger alarms like the dexcom but for gathering data about how exercise/diet effects your levels it should do the job nicely I think. edit: The starter pack costs £159.95, see https://www.freestylelibre.co.uk/libre/products/starter-pack.html https://www.freestylelibre.co.uk/libre/products/starter-pack...
  - thesehands 9y ago
    The sensors are quite pricey to get, each lasting roughly 2 weeks. Unfortunately the sensors aren't available on prescription yet. Let's hope this changes.
  - cyunem 9y ago
    These were recently included in the coverage given by the danish government (at least in my area) and this is probably the biggest quality of life improvement I have received in at least 10 years of diabetes. Even though it's not as clever as some of the other systems, being able to get an idea of the level without having to find a secluded spot and prick my finger is a really great feeling. It also means I can actually check my levels while at a party for example, where previously I would put it off for a bit because it was inconvenient.
  - pimeys 9y ago
    German insurance companies cover these too and I had them about six months before switching to Dexcom system. The NFC scanner provided is not accurate at all. The values are what they are and you can't calibrate them. Luckily if you own an Android phone with NFC reader you can use xDrip+ to scan the values and xDrip+ allows calibrations, so the measurements reflect your blood sugar much more accurately. I'm having trouble with not feeling hypoglycemias and I'm having them quite often at night. Freestyle Libre by default doesn't automatically measure your glucose levels, but there is a hack with Sony Smartwatch 3, a strap and very custom and hacky android version which enables the NFC reader in Sony and you can get alarms to your phone on low glucose levels. It worked and saved me a couple of nights, but the Libre chips break easily and the system was kind of a drag to use in the end.
ferongr 9y ago
Europe is not a country. I'd wager less prosperous countries do not cover such devices.

acoster 9y ago

My partner is type 1 diabetic, and CGMs were a game changer for her (they started rolling out in Switzerland last year). She's been using the FreeStyle Libre (https://www.freestylelibre.co.uk/libre/ https://www.freestylelibre.co.uk/libre/), which uses NFC and on select markets has an Android app available, but here we still have to use the handheld reader.

CositaS 9y ago
I find the non-official Android Libre reader app 'Glimp' useful. Even though I have the official one, I keep both installed, because Glimp does less smoothing/extrapolation of the readings.
pimeys 9y ago
I seriously recommend testing xDrip+ with the Libre. Better results and you don't need to carry an extra reader device with you all the time: https://github.com/NightscoutFoundation/xDrip https://github.com/NightscoutFoundation/xDrip Pull requests are welcome too :)
- dale-cooper 9y ago
  In what way does it offer better results? There's an official android app for libre too, i'm not sure if it's available everywhere though.
  - pimeys 9y ago
    The libre measures the glucose from the interstitial fluid, which doesn't map directly to the value measured from blood. Think about coordinates, where X is the value from interstitial fluid and Y is the value from blood. You must draw a line somewhere to map the values correctly and the Libre is calibrated in the factory. For me the Libre reader was just an ok indicator about the trend, but the actual value was sometimes not even near the value shown. It's ok between the normal range 4.0-8.5 mmol/l, but I'd be suspicious about every value outside of that range. With xDrip you can input values measured from blood and the software will try to estimate as accurate values as possible, meaning that in the best case you can be quite sure about the reading, but always better to check from blood. Remember, that calibration should happen only when the levels are steady and you should calibrate from the whole range to trust the readings. Anyways at least 2-3 measurements per day from blood is suggested, even with the more expensive CGM's.