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Andy Slowey

Slowey explains the art of DIY when it comes

to diabetes technology and why it's not just

about looping (though there's that too).

Engineer Andy Slowey developed

Type I diabetes 10 years ago. He was

an early FreeStyle Libre sensor user but

has now been using Dexcom CGM for

the last three years. He has been on an

insulin pump for only one year but quickly

became a 'looper', using a DIY system

to create a closed loop insulin delivery


"The Libre came out in 2015," he said,

"So see how far we've come in the last

four years. Before diabetes, I wouldn't

leave the house without my phone, keys,

wallet. Just after diagnosis, it was phone,

keys, wallet, insulin pen, blood test kit, jelly

babies, a diary and an actual pen to fill the

diary in with, that's a lot to remember and

lug around and I'm inherently lazy."

Initially he used his own spreadsheet

to input blood test results and highlighted

highs and lows with different colours in

order to track trends. This meant he no

longer needed to carry a diary and pen

anymore, he just put the information into

the spreadsheet using his phone.

Then he used Libre, about which he

says, "I found Libre was absolutely super

for giving additional information; it was a

paradigm shift. But I did find its glucose

readings differed somewhat from my

actual blood glucose when tested with a

meter, it could be maybe 1-2mmols out.

Part of Libre's simplicity is that it does

not need to be calibrated. However, the

downside of that is that you can't boot it

back into being more accurate, so if it is

a little off it tends to stay slightly off the

whole time you are wearing it. Also, people

used to forget to bring their reader around

with them but then the DIY community

found they could scan the sensor with

their phone, and they were doing this

prior to Abbott bringing out their own

technology to do that. In other words, it

was a community-led solution."

All in this together

So who is the DIY community? Arguably,

it's everyone using insulin, as we all have

to test ourselves, dose ourselves, make

our own decisions. Says Slowey, "Let's

face it, hall diabetes self-care is the DIY,

we don't have a doctor with us all day."

Then there is DIY APS, a rather

impenetrable phrase unless you know

it stands for. OK, so DIY is easy, APS

though stands for 'artificial pancreas

system'. Now, when it comes to sorting

out an insulin pump that automatically

delivers or stops insulin things can get

complicated. These DIY solutions have

involved writing code as any closed loop

system operates on an algorithm. Indeed,

some people literally build their own kit,

but that's not the majority. Says Slowey,

"While it is true that companies supplying

diabetes kit may put their tools through

vigourous testing, but the fact is that in

terms of their inception few minds are

involved. But if you have access to a

computer, some instructions and work

with the DIY community you are likely to

be able to sort yourself out with a form of

DIY APS. If you want to do DIY APS, then

you can."

No pump supplier can ever support

their products being hacked into. Once

you start doing this, you are on your own,

apart from the support you can get from

the rest of the DIY community. "Is this like

the Wild West?" asked Slowey, "Probably.

There's a FreeStyle Libre reader called the

Miao Miao which you clip onto the Libre

sensor and it beams into directly into an

app on your phone rather than havging

to swipe. One of these apps is called

Tomato. another software solution is

called X-Drip. On iOS there's something

called Spike. Most of these then in turn

works with NightScout and which now

allows you to share your BG readings

online. The final part of the puzzle control

algorithm, one is called Android APS, of

which there are several versions. There is

also something called Loop Kit that works

with something called the Riley link."

What you need to create an artificial

pancreas system are the following

components: First, a CGM sensor;

Second, something that works as a

bridge or an adapter - for example

Miao Miao; plus CGM software. With

DIY systems there is also an aspect of

sharing and putting info into databases

in order to learn. What's new is that data

continued over


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