Continuous tissue glucose measurement (CGM) to drive the therapy of diabetes mellitus

This system consists of a rtCGM system (Enlite4), which provides the pump with dosing values for basal insulin delivery every 5 minutes. The patient does not need to perform basal rate programming. However, the carbohydrate estimation and delivery of the insulin must be made by the patient before the meal, which keeps the system in balance. One blood glucose value is needed to to calibrate  the new sensor when it is fitted. The data can be read out from the pump as usual or sent to a smartphone via an app.

This system will be adopted by the health insurance companies in Austria from December 2021. The demo version can be opened under the following link. With this system, the setting on the insulin pump is described differently than here on the homepage and also exercise must be carried out with the change of the glucose limits. This procedure is currently not described here. If you are interested in the system you can contact me at korbsch.md@gmail.com

mylife CamAPS FX AID system

tandem t:slim x2  control-IQ AID system

There is a self-assembly rileyLink with the rtCGM System Dexcom G5 Mobile or G6 and following insulin pumps Medtronic Veo, Roche AccuCheck Combo or Insulet OmniPod. With these devices and an I phone, a loop system can be created. To create an Apple Calculator is needed.This loop system has no CE mark and is not tested. The US Food and Drug Administration has warned against its use.This system has no security features.If you are interested in a self-build hybrid loop system, you have to do it on your own responsibility.

Further steps under the following link: https://loopkit.github.io/loopdocs/

The first experience with the system shows that the loop system has to be set very precisely in order to minimize the risks. In the system, the carbohydrates eaten have to be very accurately estimated and entered into the system.

Another variant, FreeAPS, has an autobolus function and a retrospective control in order to detect an increase in glucose due to protein and to intercept it with insulin. The function with the retrospective control can also be used to implement a completely closed loop system, in which case no more carbohydrates have to be specified. To do this, however, the autobolus function must be set to 100%. In order to avoid values above 200 mg/dl, however, a meal bolus can be given as a fixed dose before the meal to improve the course.

Aerob exercise can be done with the system with special settings.

The following parameters must be specified. After 1-2 weeks, the basal rate can be trimmed by autotuner. For this, a data documentation must be done in Nightscout.

Hybrid Loop System

Correction range not below interrupt threshold. For example: during the day 90-95, at night 85-85 mg/ dl
Interruption threshold: 82 mg/dl
Administration limits: max. IU / h / (2,5 times the maximum normal basal insulin dose per hour)
Max. bolus I.U.
Insulin model: to choose