[ExI] Insulin pump (artificial pancreas)

Tue Nov 20 02:15:58 UTC 2012

Hi Folks,

I wrote my original post targeting people completely ignorant about 
pumps and diabetes.  So it's great to have at least some people more 
knowledgeable on the subject here, and take this conversation up a 
level.  I'm familiar with most of this, and do have the latest real time 
glucose monitoring system (if you can really call it that).  It is the 
monitoring that is very expensive and still highly unreliable, when done 
in real time, and that is the real problem why we don't have a real 
artificial pancreas yet.

BillK mentioned: "I should be able to get one in a few years".

Yea, tell me about it.  When I was first diagnosed with this, back in 
1982, that's what I heard back then:  "They'll have a cure or artificial 
pancreas in a few years".  And I've constantly heard this non stop from 
everyone since then.

I still don't see any evidence that we are anywhere near an affordable, 
accurate, real time glucose monitoring system.

And security was mentioned, as if an android app would be less secure - 
and that is completely wrong.  If you had an android app, at least there 
could be some type of security.  What I have now has zero security.  If 
someone had a radio adapter, which I have, they could easily take the 
entire system over, by sitting behind me in a theater or on a buss, or 
something - and I'd never know.

And it's just the programming of the system that drives me crazy, on 
both the monitoring and the controlling side.  It is completely brain 
dead, as if it was targeted for a 90 year old technophobe that can't 
understand anything.  It makes it impossible to get any of the good 
technical trending information that could make my life many times better 
and more healthy.  They program operations to go off at all the wrong 
times (like 3:00 am, when the sensor expires, when I have a sensor that 
is really working relatively good...) and it just still sucks, and 
again, most of this stuff, you can tell, is because they're trying to 
cover their but, so they won't be sued, to say nothing of simply 
primitive technology.

Brent

On 11/19/2012 12:15 PM, Charlie Stross wrote:
> Secondary point: you really want a medical device like this to be bulletproof! It's pumping insulin into you -- if something goes wrong it can potentially put you in a coma or kill you.
>
> I would be very wary of allowing an external interface such as an android app to control (as opposed to monitor) such a device. Given the prevalence of malware already afflicting in-hospital computer controlled appliances, and the risks entailed in software updates to such devices (which is why they tend to be overrun by malware -- they're running old, unpatched OS editions because you can't patch them without having to recertify the entire system as medically safe), why go looking for trouble?
>
> A standard API to allow smartphones to monitor your insulin pump, graph blood glucose levels and flow rates, and so on, would be a good idea. But allowing unsecured external computers to control it? That's just asking for malware that holds you to ransom -- for your life!
>
>
> -- Charlie
>
> On 19 Nov 2012, at 18:09, BillK <pharos at gmail.com> wrote:
>
>> On Mon, Nov 19, 2012 at 5:07 PM, Brent Allsop wrote:
>>> What troubles me, is why is medical technology even worse?  For example, I
>>> have an insulin pump (artificial pancreas) because I’m a type 1 diabetic.
>>> Since this technology is far more than 10 years old, it is basically killing
>>> me, compared to what it could be.  Instead of having an android app, that
>>> displays the information on my nice new 720P resolution color smart phone,
>>> it attempts to display it on a 64 x 128 pixel black and white LCD display,
>>> that is basically technology from the 80s.  And this is only one of a
>>> gazillion things that are killing me, compared to what it could be.
>>>
>>> The other thing is, the crude monitoring system isn’t connected to the
>>> insulin delivery system – i.e. no automated control.  So I have to do
>>> everything myself – including making mistakes – that could kill me.  The
>>> manufactures of the device could clearly lesson this risk, but of course,
>>> such would expose them to risk of being sued – so they completely avoid
>>> anything like that.  So, their basically happy to let me make mistakes and
>>> destroy my life, as long as they aren’t providing anything that would expose
>>> them to any risk.
>>>
>>>
>> What you are requesting is a full Artificial Pancreas. This is a
>> worldwide project and trials are now underway. You should be able to
>> get one within a few years.
>> <http://en.m.wikipedia.org/wiki/Artificial_pancreas>
>>
>> In the meantime, it sounds as though you should be able to get a more
>> up-to-date insulin pump.
>> JDRF says, Quote:
>> The latest-model pumps have built-in dosage calculators that manage
>> the complex diabetes math that you previously had to do yourself. This
>> feature will enable you to program different basal insulin delivery
>> rates for different times of the day, depending on changing needs. You
>> can reduce the basal rate before exercise or change the rate at night
>> to help prevent overnight lows.
>>
>> These pumps can calculate how much insulin is still working from the
>> previous bolus dose. Some manufacturers include such additional smart
>> features as programmable reminders and alerts, information download
>> capabilities that allow you to save information to a computer to keep
>> a record, a carbohydrate database (containing carbohydrate amounts for
>> many foods to eliminate guesswork), variety in styles of infusion
>> sets, and child lockout features.
>>
>> To learn more about what pumps can do, check out the websites of pump
>> manufacturers:
>> LINKS:
>>     http://www.animascorp.com/
>>     http://www.delteccozmo.com/
>>     http://www.disetronic-usa.com/
>>     http://www.minimed.com/
>>     http://www.myomnipod.com/
>> ------------
>>
>> BillK
>>
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