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Endo Apps: The DIY Artificial Pancreas

— Type 1 diabetics and their parents find solutions for closed-loop control.

MedpageToday
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I recently saw a 35-year-old type 1 diabetic patient who is on an insulin pump. While talking about the future of diabetes management, I mentioned the artificial/bionic pancreas project.

She smiled at me and said, "About 16 years ago, when diagnosed with diabetes for the first time, I was told that I will be wearing an artificial pancreas in a few years. It never happened."

People like her were living with hope that one day their lives would be transformed because of the artificial pancreas.

While they were waiting, a few citizen scientists decided that they were not going to wait. The movement was born. They decided to hack current diabetes devices to make them better.

As the saying goes, necessity became the mother of invention. Parents of children with type 1 diabetes always worry about their child's blood glucose. They know that low blood glucose could put them into a coma, or consistently high blood glucose could require a hospital admission. Monitoring their blood glucose when they were at school or at play was a challenge.

Two dads, John Costik and Lane Desborough, joined forces to develop a system that could send the continuous glucose monitoring (CGM) data to the cloud -- thus, "" was born.

The Nightscout system is not an off-the-shelf solution. It is a do-it-yourself (DIY) rig that allows people using Dexcom G4 CGM to send glucose data to the cloud using a mobile phone. This can then be accessed through any browser using a computer, smartphone, or a pebble smartwatch.

This is not FDA approved, nor does it come with any warranty. According to the Nightscout website, the minimum initial setup cost is $100.

Online communities share stories of parents who have been able to take action to prevent low blood glucose in their children. Knowing their children's blood glucose in real-time gives them peace of mind.

Not everyone is a fan of the Nightscout system. For some parents, it could be an emotional roller coaster to see their children's blood glucose rise and fall. Some would like their grown-up children to be responsible for their own blood glucose. But most parents with younger kids have only praise for the system.

Since it requires a lot of components to work together, there is a chance of system failure. This can happen if the connected phone runs out of charge, or when there is a server outage.

Other solutions have come up in the meantime as well. Recently, Dexcom came out with that allows remote viewing of CGM values with an iPhone or iPod touch.

The DIYPS () was also born from necessity. Dana Lewis and Scott Leibrand initially set out to make the CGM alarm better and they ended up developing an "artificial pancreas." The system uses a , , a , and the .

DIYPS can monitor CGM data in real-time from any Internet-enabled device. Using the data fed into the system, the DIYPS predictive algorithm can make recommendations to improve blood glucose.

According to the DIYPS website, the engineers were able to close the loop in December 2014, thus making it a fully functional artificial pancreas (again, one that is not FDA approved). Dana Lewis also started the OpenAPS initiative to help accelerate the developments of artificial pancreas systems.

While patients wait for FDA-approved solutions, some inventive patients and their families have already taken matters into their own hands.

Endo Apps is a blog about the latest digital technologies in diabetes and endocrinology. , is an endocrinologist at Mercy Hospital in Springfield, Mo.

Disclosures

Thomas developed the App. He disclosed no financial relationships with industry.