#OpenAPS and the DRIVE to DIY DIABETES TECHNOLOGY

OpenAPSthe open source artificial pancreas system

+DIY Diabetes

Mark [email protected]

Youneverleavethecar

Learn to use this really well,

and sometimes you get tofocus on this.

Your permanent reality:

It’s up to youhow often you check the speedometerhow often you make adjustmentswhether you drive on dangerous roads

how you drive

I’m doing my bestto drive this car

What could this car be doingto make my drive easier?

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

Why OpenAPS

What it’s like to use OpenAPS

What OpenAPS is for

What DIY Diabetes is for

Feedback loop

Reality Ideal

nah, not for me

Nightscout + Dexcom Nightscout + Medtronic

Feedback loop

Reality Ideal

Nightscout for Medtronicusing RileyLink

https://github.com/ps2/rileylink

Feedback loop

Reality Ideal

graph of last 3 hours

insulin on board

https://github.com/mddub/nightscout-osx-menubarhttps://github.com/mddub/urchin-cgm

Feedback loop

Reality Ideal

OpenAPS

nah, not for me

Feedback loop

Reality Ideal

Me

loop (v):to use a closed feedback loop artificial pancreas

CareLink USB stick

USB battery packRaspberry Pi

portable computer

Dexcom CGM receiver

Why OpenAPS


What OpenAPS is for


CGM distribution by week

Dexcom + Nightscout OpenAPS

MiniMed Enlite sensor

Overnight CGM distribution by week(02:00-08:00 only)

Dexcom + Nightscout OpenAPS

MiniMed Enlite sensor

CGM distribution by hour

(94 days)

Dexcom + Nightscout

Dexcom + Nightscout +OpenAPS

(138 days)

Waking up

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

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?

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

Lower highs

Higher lows

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

“You’re spending so much more time on your diabetes than you ever were before.”

Time spent managing diabetes

“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

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

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.”

Contributors to OpenAPS documentation

May 2015 Aug 2015 Nov 2015 Feb 2016 May 20160

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Source: GitHub

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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# of

Loo

pers

Why OpenAPS


What OpenAPS is for


This is a Fitbit scale

• Costs over $100• Proven less accurate than other scales• Yet tens of thousands sold, because it has Wi-Fi

Fitbit data flowDevice

Wi-FiCloud

Open APIInterfaces/

Applications

novel applications unforeseen by the

device maker


Wi-FiCloud

Open APIInterfaces/

Applications


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


Wi-FiCloud

Open APIInterfaces/

Applications

Diabetes data flowDevice

Wi-FiCloud

Open APIInterfaces/

Applications

Private protocols

Device “Reader”Private

protocols

Phone/Computer

Cloud

PrivateAPIs

PrivateAPIs

Vendor-Approved

Apps

Private protocols


protocols

Phone/Computer

Cloud

PrivateAPIs

PrivateAPIs

Vendor-Approved

Apps

OpenAPS actually isn’t an artificial pancreas.

OpenAPS is an open platform which enables you to build one.

Private protocols


protocols

Phone/Computer

Cloud

PrivateAPIs

PrivateAPIs

Vendor-Approved

Apps

Private protocols

Device “Reader” Phone/Computer

OpenAPS

Cloud

PrivateAPIs

PrivateAPIs

Vendor-Approved

Apps

“Reader”Private

protocols

Device Phone/Computer

OpenAPS

“Reader”

OpenAPS options: hardware

Private protocols


Intel EdisonRaspberry Pi RileyLink tinyAP

OpenAPS

?

Private protocols


OpenAPS

Dosing code“Reader”

OpenAPS options: dosing algorithm

OpenAPS options: dosing algorithm

Private protocols


OpenAPS

Dosing code“Reader”

openaps-doseoref0 simPancreas tinyAP

Private protocols


OpenAPS

PWD“Reader”

OpenAPS options: interface

OpenAPS options: interface

openaps-monitorNightscout LoopKit

Private protocols


OpenAPS

PWD

Urchin

“Reader”

OpenAPSserves many different needs

in many different ways.

DIY Diabetesserves many different needs

in many different ways.

Why OpenAPS


What OpenAPS is for


Private protocols


protocols

Phone/Computer

Cloud

PrivateAPIs

PrivateAPIs

Vendor-Approved

Apps

DIY Diabetes: opening device data

Private protocols


protocols

Phone/Computer

Cloud

PrivateAPIs

PrivateAPIs

Vendor-Approved

Apps

Nightscout

Freestyle Libre

Freestyle Libre + Glimp app

http://www.deebee.it/?p=1411

Upload data to the cloud instantly without wires

Freestyle Libre + LimiTTer

http://joernl.github.io/LimiTTer/

Turn the Libre into a CGM

DIY Diabetes: opening device data

Private protocols


protocols

Phone/Computer

Cloud

PrivateAPIs

PrivateAPIs

Vendor-Approved

Apps

DIY Diabetes: novel interfaces

Private protocols


protocols

Phone/Computer

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

LoopKit

https://github.com/loudnate/LoopKit

Temporary targets

https://github.com/nightscout/cgm-remote-monitor

Urchin

UnopinionatedRidiculouslyConfigurableHuman Interface toNightscout

https://github.com/mddub/urchin-cgm

DIY Diabetes: novel interfaces

Private protocols


protocols

Phone/Computer

Diabetes is already DIY.

Why OpenAPS


What OpenAPS is for


…Why?



It would transform the way I drive.

Of course you hotwire the car.

It’s not about the car.

It’s about the drive.

Misconception

“DIY Diabetes”“Diabetes”

It’s not about the car.

It’s about the drive.

Authorized

access ?

#WeAreNotWaiting

#OpenAPS and the DRIVE to DIY DIABETES TECHNOLOGY

Health & Medicine

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