History and Perspective on DIY Closed Looping

Abstract

People with diabetes have been experimenting and self-modifying diabetes devices and technologies for many decades, in order to achieve the best possible quality of life and improving their long-term outcomes. There are now hundreds of individuals using DIY closed loop systems globally. They work similarly to commercial systems at a basic level, automatically adjusting and controlling insulin dosing, but are different in terms of transparency, access, customization, and usability. The potential downsides to DIY closed looping include varying responses from individual HCPs, who may be concerned about their own liability. However, initial outcomes from this self-selected community (including adult and pediatric populations globally) have been positive. There have now been several studies documenting improvements in A1c, time in range, and other outcomes such as quality-of-life benefits. More studies on quality-of-life improvements and more collaboration between companies and the community are recommended.

Keywords: #WeAreNotWaiting; APS; OpenAPS; artificial pancreas; automated insulin delivery system; closed loop.

Figure 1.

Time in range before/after DIY closed loop initiation.

Figure 2.

A1C before/after DIY closed loop initiation.

Figure 3.

Hypoglycemia and hyperglycemia before/after DIY closed loop initiation.