Wednesday, April 8, 2015

Engineer dads to the rescue: DIY glucose monitoring and the first true artificial pancreas

Diabetes
Getting just the right amount of insulin can be difficult for a diabetic. Not enough and blood sugar can soar, while too much insulin will quickly put you into a coma. For parents of young children coming of school age, these concerns are compounded by the inexplicable shortcomings of proprietary technologies that get between them and peace of of mind. While many users have given the purveyors of inadequate glucose sensors and pumps a piece of their own mind, a pair of engineer dads are now taking matters into their own hands.

John Costik and Lane Desborough are the creators of Nightscout, a project to put continuous glucose monitoring (CGM) data into the cloud where parents, and everyone, need it to be. Their system is decidedly not FDA-approved and does not come with any warranty. It is a DIY rig that takes glucose data from a sensor like the Dexcom G4 CGM and uses a phone to put it in a place where any smart device or watch can access it. What about privacy, what about security? The cries of the enemy of the open medicine movement are not heard here. A five-year-old’s blood sugar is neither a national secret nor a grave breach of security, in fact, for those to whom it may concern, it is the antithesis of privacy.

Pebble

For users of devices like cochlear implants, pacemakers, or even deep brain stimulators, what you tend to see at the point where the customer reaches their limit of frustration and makes material effort towards a DIY solution, is a manufacturer rollout of some laughable excuse for inclusion — an archaic spreadsheet of untimely data in some esoteric format in the case of heart rhythm, or connection through a equally exclusive suite of proprietary devices in the case of instrumentation to augment hearing. In the case of CGM, there is now something called Dexcom Share. It provides for simple Bluetooth connectivity specifically to adherents of the iPhone-and-iPod school of thought. But fortunately, the hacker community is now too smart for any of that.

Glucose monitoring is just the beginning. Dana Lewis and Scott Leibrand are the creators of DIYPS, the Do-It-Yourself Pancreas System. Also born of necessity, this system combines a Medtronic pump, Dexcom CGM, a Raspberry Pi, and CareLink USB, to provide what is essentially the first closed-loop artificial pancreas. It also incorporates predictive algorithms to provide additional recommendations to tweak glucose levels. In the real world of medical devices, ‘closed loop’ is often something in the eye of the beholder. A DBS device implanted in a clinical trial, for example, may have the capability to record and stimulate different areas of the brain. But that doesn’t mean the recorded data is actually used to control the stimulation in real time — particularly if the only place that data goes is back to the manufacturer’s headquarters.


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