My diabetes kit Tim Street, diabetech, DIY looping, Open APS, Tim Omer type 1 diabetes

KITLIVING

became the crest of a wave. It probably

helped that my Twitter handle (name) is @

Tims_Pants, which stood out."

How does Street see social media

now? "There are upsides and downsides

to using social media. The downside

is that people can be judgemental and

even abusive, 'keyboard warriors' about

their viewpoints. The upside is that you

can meet more people who are dealing

with the same things that you are, and

that can help. Not only is there a sense

of community but you may pick up tips or

things to think about. There might be 50

people in a forum at any one time. There's

a great sense of sharing and sometimes

these lead to face-to-face get-togethers,

a meet up down a pub."

The science of one

As the blog continued and gained a

following, Street started to try to do his

home experiments in a more quantitative

way. "I used N=1, which is a way to

say that the experiments were being

done only on one person, myself," he

explains, "Therefore, I would only deliver

and analyze one set of results, not at all

like a trial where you might have many

people involved and the results would

be aggregated and given as averages.

Is it scientific? I tried to take a statistical

and analytical approach, setting each

one up as a project to capture the data.

Then I use analytical tools to try to assess

what is learnt and what further questions

there may be as a result. I try to put in

a consistent approach using traditional

mathematics as well as my imagination."

It's this kind of approach and attitude

that has led to other people with diabetes

creating 'DIY looping', also known as

Open APS (artificial pump system). Street

says that there is a misconception that

this is hacking, but it's not. "Hacking is

associated with cybercrime, cracking

passwords, doing illegal things and

gaining unauthorised access to systems

such as those of banks or governments.

This is illegal exploitation of a computer

system for dubious aims," he says.

DIY looping came about when users

with a mind for this kind of thing realized

that some CGMs deliberately had an

open signal, which a relevant device

could listen out for, read the data, store

it and even present it as graphs for easier

understanding. It led to the #nightscout

and #wearenotwaiting movement. "So,

it's not hacking, just picking up the

CGM signal," he says. "Other people

with an interest in science, engineering

and their own diabetes were figuring

out how the technology worked, how it

communicated. Nothing is broken into."

We interviewed another early user

of Open APS in 2017, Tim Omer. In

September 2017 (to read, click on the

Front Cover image on the right). Tim

Street met Tim Omer and used his open

loop system for four months, before

building his own Open APS system in

August 2016. Says Street, "It's really a

matter of understanding the protocols

involved in order to intervene to tell the

pump to do the same things - like carb

count or bolus advise - but personalize it

in order to better control the outcome, i.e.

to gain even better control."

Back when we met him, Tim Omer

argued that we're all taking risks every

day with our diabetes care. Each decision

we make (or guess) for delivering a bolus

or counting carbs or whether or not to do

any exercise comes with a risk. Similarly,

Street says, "Insulin dosing is already a

"DIY looping and Open APS may sound like

they are cobbled together, but in fact we use

standard software delivery checks and test the

code thoroughly before it is released.

huge risk as you are handling a potentially

lethal drug. Commercial companies will

tell you a lot about the product but you're

not going to hear as much about what it's

actually like to use it or necessarily see

anyone's real data.

"DIY looping and Open APS may

sound like they are cobbled together, but

in fact we use standard software delivery

checks and test the code thoroughly

before it is released. It is a rigorous testing

process and therefore not risky, plus it

can still be tweaked and amended by the

user. It means that I understand what I'm

changing and why. There is inherent risk

in living with Type I diabetes. I don't feel

that using the tools on hand to make my

own control the best it can possibly be is a

risk, and I share what I learn. If others find

that interesting or insightful, then great."

www.diabettech.com

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