3 ms·

I know folks that work on Nightscout and I agree with everything in this post. I find them to be very thoughtful and circumspect about the work (the contributo

by arafa 7y ago

I know folks that work on Nightscout and I agree with everything in this post. I find them to be very thoughtful and circumspect about the work (the contributors often have T1D or family with T1D). Besides that, a closed loop system (which as yet is only partially implemented or is still somewhat inconsistent) is a holy grail for a lot of these folks. Most of them are already well acquainted with manually managing insulin and the existing products and can handle any mishaps for the most part.

gh02t 7y ago
I don't really understand in detail how insulin pumps work, so I want to ask why are there not commercial closed-loop systems available? It seems like an obvious development that pump makers should have implemented a long time ago. Is there a complication that makes it harder than it sounds, or is it something like regulatory concerns or just plain laziness?
- GiorgioG 7y ago
  Few competitors, no reason to innovate. And they're charging $8-12,000 for a new pump setup. That was our experience 5 years ago with Medtronic. Not a single update in 4 years with our son's 530g pump. With his new pump (from Tandem) we're expecting a pretty big software patch/upgrade later this year. Beta Bionics is working on their artificial pancreas (dual hormone) that should be out next year. So newer/more-nimble players are forcing the bigger companies to start innovating. Having said that, it never comes soon enough ;)
  - ZucchiniZe 7y ago
    I got a chance to try out the beta bionics artificial pancreas in a research trial and it is a truly new innovation in this field, it lifted about 90% of the constant thinking about bolus and blood sugar from me and allowed me to live my life. It truly deserves all the hype that it is getting.
    - GiorgioG 7y ago
      Wow that's great to hear! Was it insulin-only or did it also have glucagon onboard? I know they're working towards releasing the insulin-only version first. I can't wait for the dual-hormone version to become available. It'll allow my wife and I to sleep through the night without worrying that our son won't wake up when he drops too low.
  - thecosas 7y ago
    Sidebar: Tandem's Q1 2019 results came out today and they're doing pretty dang well. http://investor.tandemdiabetes.com/news-releases/news-release-details/tandem-diabetes-care-announces-first-quarter-2019-financial http://investor.tandemdiabetes.com/news-releases/news-releas... Operating margin is still negative, but it's improved tremendously year over year.
- bleair 7y ago
  In short, real humans and these medical devices are inexact. The device must choose “How much insulin should be dosed?”. Lawsuits argue medical devices should be flawless, so no company will bring out a device that could be pointed out as causing an incorrect amount of drugs being delivered The open source insulin pump and continuous-glucose-monitors as a feedback systems are just incredible BUT they require the user to be very aware of what is easy and reliable and what can be flaky (see all the details about pod screamers - e.g. the pod can’t continue, or drift in cgm data)
- emiliobumachar 7y ago
  Every time a self-driving car kills one person, it's national headlines for a week, with no shortage of people calling for the people responsible to be jailed. It will be like that the first few times that a commercial closed-loop system kills a person.

by arafa 7y ago

gh02t 7y ago

I don't really understand in detail how insulin pumps work, so I want to ask why are there not commercial closed-loop systems available? It seems like an obvious development that pump makers should have implemented a long time ago. Is there a complication that makes it harder than it sounds, or is it something like regulatory concerns or just plain laziness?

GiorgioG 7y ago
Few competitors, no reason to innovate. And they're charging $8-12,000 for a new pump setup. That was our experience 5 years ago with Medtronic. Not a single update in 4 years with our son's 530g pump. With his new pump (from Tandem) we're expecting a pretty big software patch/upgrade later this year. Beta Bionics is working on their artificial pancreas (dual hormone) that should be out next year. So newer/more-nimble players are forcing the bigger companies to start innovating. Having said that, it never comes soon enough ;)
- ZucchiniZe 7y ago
  I got a chance to try out the beta bionics artificial pancreas in a research trial and it is a truly new innovation in this field, it lifted about 90% of the constant thinking about bolus and blood sugar from me and allowed me to live my life. It truly deserves all the hype that it is getting.
  - GiorgioG 7y ago
    Wow that's great to hear! Was it insulin-only or did it also have glucagon onboard? I know they're working towards releasing the insulin-only version first. I can't wait for the dual-hormone version to become available. It'll allow my wife and I to sleep through the night without worrying that our son won't wake up when he drops too low.
- thecosas 7y ago
  Sidebar: Tandem's Q1 2019 results came out today and they're doing pretty dang well. http://investor.tandemdiabetes.com/news-releases/news-release-details/tandem-diabetes-care-announces-first-quarter-2019-financial http://investor.tandemdiabetes.com/news-releases/news-releas... Operating margin is still negative, but it's improved tremendously year over year.
bleair 7y ago
In short, real humans and these medical devices are inexact. The device must choose “How much insulin should be dosed?”. Lawsuits argue medical devices should be flawless, so no company will bring out a device that could be pointed out as causing an incorrect amount of drugs being delivered The open source insulin pump and continuous-glucose-monitors as a feedback systems are just incredible BUT they require the user to be very aware of what is easy and reliable and what can be flaky (see all the details about pod screamers - e.g. the pod can’t continue, or drift in cgm data)
emiliobumachar 7y ago
Every time a self-driving car kills one person, it's national headlines for a week, with no shortage of people calling for the people responsible to be jailed. It will be like that the first few times that a commercial closed-loop system kills a person.