#OpenAPS and the DRIVE to DIY DIABETES TECHNOLOGY
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Transcript of #OpenAPS and the DRIVE to DIY DIABETES TECHNOLOGY
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Youneverleavethecar
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Learn to use this really well,
and sometimes you get tofocus on this.
Your permanent reality:
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It’s up to youhow often you check the speedometerhow often you make adjustmentswhether you drive on dangerous roads
how you drive
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I’m doing my bestto drive this car
What could this car be doingto make my drive easier?
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I don’t know how to hotwire a carI don’t have time to learn to hotwire a car
I don’t want to damage my car
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Why OpenAPS
What it’s like to use OpenAPS
What OpenAPS is for
What DIY Diabetes is for
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Why OpenAPS
What it’s like to use OpenAPS
What OpenAPS is for
What DIY Diabetes is for
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Feedback loop
Reality Ideal
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nah, not for me
Nightscout + Dexcom Nightscout + Medtronic
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Feedback loop
Reality Ideal
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Nightscout for Medtronicusing RileyLink
https://github.com/ps2/rileylink
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Feedback loop
Reality Ideal
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graph of last 3 hours
insulin on board
https://github.com/mddub/nightscout-osx-menubarhttps://github.com/mddub/urchin-cgm
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Feedback loop
Reality Ideal
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OpenAPS
nah, not for me
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Feedback loop
Reality Ideal
Me
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Feedback loop
Reality Ideal
Me
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loop (v):to use a closed feedback loop artificial pancreas
CareLink USB stick
USB battery packRaspberry Pi
portable computer
Dexcom CGM receiver
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Why OpenAPS
What it’s like to use OpenAPS
What OpenAPS is for
What DIY Diabetes is for
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CGM distribution by week
Dexcom + Nightscout OpenAPS
MiniMed Enlite sensor
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CGM distribution by week
Dexcom + Nightscout OpenAPS
MiniMed Enlite sensor
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CGM distribution by week
Dexcom + Nightscout OpenAPS
MiniMed Enlite sensor
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Overnight CGM distribution by week(02:00-08:00 only)
Dexcom + Nightscout OpenAPS
MiniMed Enlite sensor
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CGM distribution by hour
(94 days)
Dexcom + Nightscout
Dexcom + Nightscout +OpenAPS
(138 days)
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Waking up
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I woke up one morning, and I was like,“How do I feel today? What’s my day going to be like?”instead of,“What’s my blood sugar and how can I correct that?”
—Sara Krugman
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Making decisionsBG: 65 mg/dL
Rate of change: -3 mg/dL/5min
Deceleration: +0.5 mg/dL/(5min)2
Insulin on board: 0.3 units
Q: How many carbs right now to land at 90 - 110 in 1.5 hours?
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Making decisionsBG: 65 mg/dL
Rate of change: -3 mg/dL/5min
Deceleration: +0.5 mg/dL/(5min)2
Insulin on board: 0.3 units
Q: How many carbs right now to land at 90 - 110 in 1.5 hours?
A: Trick question, it’s f*&#ing impossible
I err on the side of over-correcting, and let OpenAPS blunt the spike
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Lower highs
Higher lows
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Building OpenAPS
• Here’s some instructions• They may not be complete• Here’s how to contribute to the instructions• You may have issues• Here’s how to contribute your fixes
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“You’re spending so much more time on your diabetes than you ever were before.”
Time spent managing diabetes
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“You’re spending so much more time on your diabetes than you ever were before.”
Time spent managing diabetes
Time spent troubleshooting hardware & software
Time spent making diabetes decisions
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“You’re spending so much more time on your diabetes than you ever were before.”
Time spent managing diabetes
Time spent troubleshooting hardware & software
Time spent making diabetes decisions
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Building OpenAPS
• Now it’s a few moments of monitoring per day
• You learn how it works and how it can fail …just like your pump and CGM
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Trusting OpenAPS
Safety is built into the design of the dosing algorithm.• Temporary basal rates, not boluses• Conservative limits• Conservative adjustments• Adjustments match what a human would do
It’s open source.“Given enough eyeballs, all bugs are shallow.”
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Contributors to OpenAPS documentation
May 2015 Aug 2015 Nov 2015 Feb 2016 May 20160
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20
30
40
Source: GitHub
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Credit: Chris Hannemann / Dana Lewis
OpenAPS users
Sep 2014 Dec 2014 Mar 2015 Jun 2015 Sep 2015 Dec 2015 Mar 2016 Jun 20160
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20
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# of
Loo
pers
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Why OpenAPS
What it’s like to use OpenAPS
What OpenAPS is for
What DIY Diabetes is for
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This is a Fitbit scale
• Costs over $100• Proven less accurate than other scales• Yet tens of thousands sold, because it has Wi-Fi
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Fitbit data flowDevice
Wi-FiCloud
Open APIInterfaces/
Applications
novel applications unforeseen by the
device maker
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Fitbit data flowDevice
Wi-FiCloud
Open APIInterfaces/
Applications
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Fitbit data flowDevice
Wi-FiCloud
Open APIInterfaces/
Applications
…an application which Fitbit knows it won’t think of which Fitbit will not
invest in which adds value to
Fitbit’s platform
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Fitbit data flowDevice
Wi-FiCloud
Open APIInterfaces/
Applications
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Diabetes data flowDevice
Wi-FiCloud
Open APIInterfaces/
Applications
Private protocols
Device “Reader”Private
protocols
Phone/Computer
Cloud
PrivateAPIs
PrivateAPIs
Vendor-Approved
Apps
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Private protocols
Device “Reader”Private
protocols
Phone/Computer
Cloud
PrivateAPIs
PrivateAPIs
Vendor-Approved
Apps
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OpenAPS actually isn’t an artificial pancreas.
OpenAPS is an open platform which enables you to build one.
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Private protocols
Device “Reader”Private
protocols
Phone/Computer
Cloud
PrivateAPIs
PrivateAPIs
Vendor-Approved
Apps
![Page 54: #OpenAPS and the DRIVE to DIY DIABETES TECHNOLOGY](https://reader035.fdocuments.us/reader035/viewer/2022081520/589c2ad51a28ab65248b5e95/html5/thumbnails/54.jpg)
Private protocols
Device “Reader” Phone/Computer
OpenAPS
Cloud
PrivateAPIs
PrivateAPIs
Vendor-Approved
Apps
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“Reader”Private
protocols
Device Phone/Computer
OpenAPS
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“Reader”
OpenAPS options: hardware
Private protocols
Device Phone/Computer
Intel EdisonRaspberry Pi RileyLink tinyAP
OpenAPS
?
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Private protocols
Device Phone/Computer
OpenAPS
Dosing code“Reader”
OpenAPS options: dosing algorithm
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OpenAPS options: dosing algorithm
Private protocols
Device Phone/Computer
OpenAPS
Dosing code“Reader”
openaps-doseoref0 simPancreas tinyAP
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Private protocols
Device Phone/Computer
OpenAPS
PWD“Reader”
OpenAPS options: interface
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OpenAPS options: interface
openaps-monitorNightscout LoopKit
Private protocols
Device Phone/Computer
OpenAPS
PWD
Urchin
“Reader”
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OpenAPSserves many different needs
in many different ways.
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DIY Diabetesserves many different needs
in many different ways.
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Why OpenAPS
What it’s like to use OpenAPS
What OpenAPS is for
What DIY Diabetes is for
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Private protocols
Device “Reader”Private
protocols
Phone/Computer
Cloud
PrivateAPIs
PrivateAPIs
Vendor-Approved
Apps
![Page 65: #OpenAPS and the DRIVE to DIY DIABETES TECHNOLOGY](https://reader035.fdocuments.us/reader035/viewer/2022081520/589c2ad51a28ab65248b5e95/html5/thumbnails/65.jpg)
DIY Diabetes: opening device data
Private protocols
Device “Reader”Private
protocols
Phone/Computer
Cloud
PrivateAPIs
PrivateAPIs
Vendor-Approved
Apps
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Nightscout
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Freestyle Libre
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Freestyle Libre
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Freestyle Libre + Glimp app
http://www.deebee.it/?p=1411
Upload data to the cloud instantly without wires
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Freestyle Libre + LimiTTer
http://joernl.github.io/LimiTTer/
Turn the Libre into a CGM
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DIY Diabetes: opening device data
Private protocols
Device “Reader”Private
protocols
Phone/Computer
Cloud
PrivateAPIs
PrivateAPIs
Vendor-Approved
Apps
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DIY Diabetes: novel interfaces
Private protocols
Device “Reader”Private
protocols
Phone/Computer
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Pump push notifications
Kid bolusesat school
Parent receives push notification
https://github.com/nightscout/cgm-remote-monitor
4:05 PMBolus: 3.0 UCarbs: 24 g
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LoopKit
https://github.com/loudnate/LoopKit
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Temporary targets
https://github.com/nightscout/cgm-remote-monitor
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Urchin
UnopinionatedRidiculouslyConfigurableHuman Interface toNightscout
https://github.com/mddub/urchin-cgm
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DIY Diabetes: novel interfaces
Private protocols
Device “Reader”Private
protocols
Phone/Computer
![Page 78: #OpenAPS and the DRIVE to DIY DIABETES TECHNOLOGY](https://reader035.fdocuments.us/reader035/viewer/2022081520/589c2ad51a28ab65248b5e95/html5/thumbnails/78.jpg)
Diabetes is already DIY.
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Why OpenAPS
What it’s like to use OpenAPS
What OpenAPS is for
What DIY Diabetes is for
…Why?
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I don’t know how to hotwire a carI don’t have time to learn to hotwire a car
I don’t want to damage my car
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I don’t know how to hotwire a carI don’t have time to learn to hotwire a car
I don’t want to damage my car
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I don’t know how to hotwire a carI don’t have time to learn to hotwire a car
I don’t want to damage my car
It would transform the way I drive.
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Of course you hotwire the car.
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It’s not about the car.
It’s about the drive.
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Misconception
“DIY Diabetes”“Diabetes”
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It’s not about the car.
It’s about the drive.
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It’s not about the car.
It’s about the drive.
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Authorized
access ?
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#WeAreNotWaiting