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Hi

Now funnily enough I know two of the people who did the trial. One is a particularly good friend of mine and this forum and it was her daughter who did it. It was done overnight. The mum had an overwhelming desire to intercede everytime the daughter dropped low ish to prevent a hypo but held back and the pump came into its own. If she is around, I'm sure she can tell you more. It is really interesting stuff and she knows far more about it than me.

For those that don't know the picture is like what my daughter wears at the moment anyway although the transmitter is not like that anymore, this is an old picture. The transmitter is now directly attached to the sensor. The transmitter is what is number 1 in the diagram. The bit that it is attached to just below is the actual sensor which has a tiny bit inserted under the skin. So there is no wire any longer. (I guess this closed loop could be like that but I would hope not).

The problems are how good are the sensors which are being improved on all the time. The readings are taken from the interstitial blood not the capillary blood like in the fingers. It is not as accurate all the time. For some it is and I have friends who do less finger tests and can purely go on the sensor readings. With Jessica and many others we can only use the sensors as a way to work out trends etc. I attach a couple of sensor downloads for Jessica. One is a really good week and the other (this last week) is not, Jessica has had a cold. Now what these downloads don't show are the hypos Jessica has had and since Monday she has had loads but what happens is the sensor is behind so it tries to catch up with the true readings and so by the time Jessica has come up from the hypo the sensor does not bother going down that low.

Jessica's pump and sensor does not do the closed loop bit, this is what is being trialled. The closed loop bit means that on the sensor reading it will make the pump do whatever is needed ie give insulin to bring down a high or stop pump to sort out a potential hypo. It is great study and one day when the sensors are better I look forward to this very much.

I have heard one of the designers do a talk about this last year and it is remarkable.


(Sorry no idea how to upload the attachments, they are too big. Have never been able to upload anything, Northerner or anyone, any ideas?)🙂🙂
 
I could help you with that later when i'm home from work Adrienne, but i'm sure someone will come along and sort it out for you before I get back :D

Why does it say it's for children? What about me?? :(:(
 
Oh it's ok, it's just the stoopid title. In the article it says: "We need to redouble our efforts to move the artificial pancreas from a concept in the clinic to a reality in the home of children and adults with type 1 diabetes."

Phew 😉
 
katie said:
Oh it's ok, it's just the stoopid title. In the article it says: "We need to redouble our efforts to move the artificial pancreas from a concept in the clinic to a reality in the home of children and adults with type 1 diabetes."

Phew 😉
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typical bbc eh? 😉
 
I am just wondering how it will work during the day, with eating and exercise etc.
With the readings lagging behind blood readings and the speed of current insulins, will the initial spike of food be quite high before it kicks in and started to bring the blood sugar down? If not can someone explain it to me as I've been trying to work it out for a while now.

It says on the article that they used different situations such as evening exercise and compared how the closed loop and the regular pump coped. On the relugar pump night were they allowed to make changes to their pump settings? For example if they normally would put on an overnight temp basal following exercise could they do that? Or did they have to just go with the normal rates?

all interesting stuff
 
Hehe thanks Adrienne 🙂 Yep Rose trialled it for 2 overnight stays. One started after her tea at 6pm, the other i think was at 4pm. Blood was taken every 15 mins from the cannula in her arm, just to see if they coincided with the sensor. It was very odd for 12 hours being totally hands off and not doing anything.

Rose did go low during the trial as Adrienne said. It was scary leaving her in a mild hypo state - she was fast asleep! but the staff could have intervened getting a glucose drip up but they really wanted to see how the algorithm coped. And it did! 🙂
 
What happened - and i don't understand it completely 😉 Was that the pump was infusing insulin depending on her levels, no one inputted the info, with the algorithm is worked it out. As she was dropping, the sensor would relay it to the laptop which told the pump to decrease the insulin. So, as she was dropping it suspended it (like the Veo i presume?) and so no insulin was going through, or if it was it was minimal. Her levels then raised by itself (although not sure how) and she came up, when the sensor picked this up the pump started infusing insulin again. 🙂
 
Thanks Becca 🙂

If anyone knows how the levels rise on there own, please let me know :D Very interesting.
 
I guess it could be from the food she had eaten? With no insulin going in the glucose was able to raise the levels? Maybe....
 
Becca said:
I guess it could be from the food she had eaten? With no insulin going in the glucose was able to raise the levels? Maybe....
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Yes that is one thing it could be :confused:

I guess you'd have to treat a hypo if you had no glucose left. Or would your liver chuck out some glycogen? or?? I don't know :D
 
katie said:
Thanks Becca 🙂

If anyone knows how the levels rise on there own, please let me know :D Very interesting.
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I think it's just the liver releasing glucose slowly. The liver does this constantly, and that's why you need your basal insulin. If your basal insulin is set right, the insulin will match the glucose released by the liver and your levels will remain steady. If the pump reduced or stopped the insulin going in, this slow release by the liver is still going on, and will raise the glucose levels because there is less insulin around. Does that help any? 🙂

sofaraway said:
I am just wondering how it will work during the day, with eating and exercise etc.
With the readings lagging behind blood readings and the speed of current insulins, will the initial spike of food be quite high before it kicks in and started to bring the blood sugar down? If not can someone explain it to me as I've been trying to work it out for a while now.

It says on the article that they used different situations such as evening exercise and compared how the closed loop and the regular pump coped. On the relugar pump night were they allowed to make changes to their pump settings? For example if they normally would put on an overnight temp basal following exercise could they do that? Or did they have to just go with the normal rates?

all interesting stuff
Click to expand...

I'm not sure how far along they are with this, but I took part in another study for the artificial pancreas with the same group where they were looking at the effects of normal life things on your blood sugar, and trying to figure out ways for the algorithm to adjust for this. The study I took part in looked at eating a large meal, and I know they were doing other studies looking at the effect of exercise and drinking alcohol. For the study I was involve in, it wasn't a closed loop as the algorithm said how much insulin I should have every 15 mins, and someone adjusted my doses manually, but the algorithm worked pretty damn well. 🙂 So I think they are working on these kinds of problems, but I think you're right in that the speed of sensor readings and insulin activity probably need to improve before an actual artificial pancreas can cope with all these things.
 
Hi
They mentioned this at my clinic appointment on tuesday & they will be starting trials with pregnant type 1's very soon, i'll let you know if i'm invited to participate in the trial. They have published a more detailed article in the "lancet" sorry i haven't got the link.
Chrissie
 
Chrissie said:
Hi
They mentioned this at my clinic appointment on tuesday & they will be starting trials with pregnant type 1's very soon, i'll let you know if i'm invited to participate in the trial. They have published a more detailed article in the "lancet" sorry i haven't got the link.
Chrissie
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Are you going to give it a shot if you are invited? I would love to give it a go and then run off with pump and the CGMS. I would guess I am a bit too far away in Edinburgh though.
 
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