
FDA approves Medtronic's 'artificial pancreas' for diabetes - helloworld
http://www.reuters.com/article/us-health-diabetes-medtronic-idUSKCN11Z04Y
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shanselman
Just to give a little more context. This is a start but it's by no means the
finish line. Additionally, this is just one company's closed source system
that is kind of the "Tesla AutoPilot" for diabetes. It will TRY to keep you in
the lines but if there is a real turn or a stop light, you absolutely need to
take control.

Go google for "OpenAPS" and "WeAreNotWaiting" for existing open source systems
that do more than this Medtronic system does...they are available now and
there are over 100 people using them 24/7.

Additional reading here:
[http://www.hanselman.com/blog/ThePromisingStateOfDiabetesTec...](http://www.hanselman.com/blog/ThePromisingStateOfDiabetesTechnologyIn2016.aspx)

Source: 25 year Type 1 diabetic who is currently "looping" with an open source
"artificial pancreas"

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shas3
Earnest skepticism: how can you trust Open APS without the rigorous testing
required from companies like Medtronic? Sure, FDA regulations are not perfect.
But they sure work in a large number of cases. While the DIY spirit of Open
APS is commendable, hypoglycemia can be extremely dangerous and the risk is
too high without FDA-level rigorous testing.

~~~
kellyisworking
Here's the inherent problem – insulin is a lot more dangerous on it's own than
with any sort of hybrid loop system. The safety having a system like openaps -
which includes a LOT of fail safes - is far greater than what a type 1
diabetic can do on their own. 1 in 20 people will die in their sleep because
of hypos because he or she simply isn't fortunate enough to feel the blood
sugar dipping and wake up to treat. The OpenAps safety measures are far far
greater than what we have as a normal person regulating their day-to-day
insulin dosing. I will sleep a lot easier knowing that I have something else
watching, determining whether the boluses he's given might be corrected
slightly so that he doesn't go low or high. Read about it at openaps.org –
look at the reference design, and read about the fail safes where the pump
will revert back to preprogrammed basal rates if batteries run out. Quite
frankly anything with Type 1 diabetes is terrifying. At the end of the day,
the risk with type 1 is too high for us to wait any longer.

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andrewtbham
In the 90s minimed brought insulin pumps to market. It was one of the first
stock I ever bought and it blew up. They regularly wrote about their primary
goal of creating an artificial pancreas. Eventually they were bought by
Medtronic and I sold my shares. Glad to see they are finally achieving their
long term goal... nearly 20 years later.

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kellyisworking
It's a great step – looking forward to the options coming in the next couple
years with Bigfoot & ILet. Glad to see this on HN – made me finally comment.

We should be complete building my husband's artificial pancreas next week
based on open source code. For those interested in what's happening in the
community – you might want to take a look at openAPS.

~~~
shanselman
cosign.

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elmin
Can someone explain why notifying the device of exercise and eating is
necessary? Is it because 5 minutes is too low of an interval, or because the
glucose sensor is slow, or because the body relies on other eating and
exercise cues to regulate insulin.

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shanselman
Because if you start exercising or eating NOW the insulin administered won't
start working for 30 min and won't peak for 90-120 minutes. Because food hits
you fast and by the time the system notices you'll have already drifted "out
of the lanes."

Diabetes Closed Loops are the same problem as controlling the Mars Rover. You
move the joystick and nothing happens for x minutes. Then you wait another x
minutes to observe the results.

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known
In people without diabetes, the beta cells make and release some insulin all
of the time. This is a “basal” level of insulin that helps the body to
function. When a person eats and their blood glucose level rises, the body
releases an extra burst or ‘bolus” of insulin to help bring the blood glucose
back into the target range. The insulin taken to manage diabetes is designed
to work the way the body works as closely as possible.
[http://www.idf.org/worlddiabetesday/toolkit/pwd/insulin](http://www.idf.org/worlddiabetesday/toolkit/pwd/insulin)

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yarou
I've always been fascinated with metabolic diseases/syndromes like diabetes.
It seems to be a symptom of the first world, i.e. affluenza, but there's this
weird sort of trade-off where it can manifest itself (type-2 specifically) and
become aggressive at a moment's notice.

Clearly there is a strong genetic component, but possibly a strong
environmental component as well. I think the markers we have right now (A1C
and blood glucose levels) are insufficient in understanding the underlying
mechanism of action for the disease.

What's even more interesting to me is the relationship between endogenous
growth hormone and insulin receptors. The relationship between IGF-1 and
insulin in particular is very interesting - IGF-1 binds to insulin receptors.

I hope that as we continue to advance in cybernetics and genomics (artificial
organs are the first step to machine/human hybrids), we will gain a better
understanding of the underlying mechanisms of the common ailments in our
society.

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robobro
You don't know what you're talking about at all. Read what type 1 and type 2
diabetes are before you talk about them.

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yarou
Clearly, I know the difference between type 1 and type 2. Type 1 is primarily
genetic, which I may not have explicitly mentioned in my comment, and type 2
is a mix of genetic and environmental factors.

Thanks for the two sentence reply fam, it really elevated the discussion.

