So its been a while since i've started looping...figured its time for a new blog. Over the past week i've been getting quite a bit of questions about looping so I figured i'd do two different blog posts.
Looping in short is a DIY closed loop system.
So what looping does is it connects my medtronic pump and my CGM to a mobile app called loop. In that app the pump and CGM are able to communicate and adjust basal rates by decreasing or lowering them depending on the algorithms BG predictions attempting to keep you in range more often.
Setting up the loop wasn't too bad, you definitely don't need to be a tech genius. The coding is all done for you and you can access it all on the loop docs, a great document, very easily designed with instructions and pictures of a step by step set up and all the trouble shootings possible.
To set up loop you need a Riley link an old Medtronic paradigm pump, a CGM (either a dexcom or a libre with a transmitter...I totally recommend the miaomiao).
Once you have the app all set up it should look something like this.
As you can see at the top tool bar there are 5 icons. The first is the green circle which means you are currently closed looping. If an error occurs the green circle will become red. Also, if the circle is a semi circle that means you are open looping which I will discuss later on.
Next you can see you blood sugar reading. This information is derived from the spike app. Which reads my miaomiao transmitter every 5 minutes.
The third icon shows the current basal changes happening at this current time. As shown in the picture my predicted blood sugar is 6.2 therefore loop has chosen to keep the basal set on my pump. Any basal changes done with your current pump basals as a starting point therefore, its vital in my opinion to have an accurate basal set before you start looping...maybe some basal testing too!
Lastly the 3rd and 4th icon is your pump reservoir and battery. Which is super cool because I get an alert to both my phone and apple watch when either of them go low!
The bottom tool bar has another 5 icons which are pretty handy! The first green one on the left is where I bolus for meals from. Simply inputting my carbs and loop calculates the amount of insulin needed based on your I:C ratio and once i confirm my pump starts bolusing. Pretty cool because I don't even need to touch my pump...just straight off my phone. And my apple watch too!
The following green on and the blur heart are pre set targets. The green on is for pre meals...if I want to be at 4.5 before a meal I will press that icon about an hour or two before my meal so loop can target my blood sugars to my desired setting. The blue heart is a similar idea but for exercise.
The orange double triangles in between them is a bolus option that doesn't include carbohydrates. So if I am correcting or over riding my pump by giving additional insulin.
So how does loop help exactly? the picture above you can see under insulin delivery...each block is a basal increase or decrease that loop adjusted my pump too throughout the day as it aims to keep me in my set target range. Loop adjusts basals in U/H (units per hour) rather than percentages
The picture on the left at the top tool bar you can see that there was a current basal decrease of -0.0625u per hour to prevent me from dipping too low. Loop adjusts if needed as it gets a new blood sugar reading every 5 minutes from my transmitter.
While being closed loop is awesome, a few situations seem to work better when i'm not looping.
When the circle is no longer fully closed that means you are in open looping mode. As you can see that while on open loop the app won't change your pump basal setting however, it will still show you its recommendation
I go to open loop when I override my pump which probably happens more times than i'd like to admit. The reason for this is because loop starts calculating I will be very low so it starts suspending my basal which defeats the purpose to my rage bolus.
Another reason, however I haven't experienced it often is when loop causes my blood sugars to become a yo-yo, going high than low than high than low...you get the point. Not Fun! This happens because the pump suspension causes the spike than a correction causes you to crash back down which makes loop suspend basal again and so on.
Going off closed loop allows you to break the cycle so you can fall into range and than go back to closed loop.
I've been looping for about a month and I think its been great! so here is my take on it with some pictures to back me up.
Definitely been in much better range over all with great over all stats! Now loop might've worked against me over the fact that i get even more anxious than before when I go high...just because since I started looping how high I go has decreased quite a bit. It also definitely reduced the amount of lows I have, although if I stop myself from overriding it would be better for sure
Looping in short is a DIY closed loop system.
So what looping does is it connects my medtronic pump and my CGM to a mobile app called loop. In that app the pump and CGM are able to communicate and adjust basal rates by decreasing or lowering them depending on the algorithms BG predictions attempting to keep you in range more often.
Setting up the loop wasn't too bad, you definitely don't need to be a tech genius. The coding is all done for you and you can access it all on the loop docs, a great document, very easily designed with instructions and pictures of a step by step set up and all the trouble shootings possible.
To set up loop you need a Riley link an old Medtronic paradigm pump, a CGM (either a dexcom or a libre with a transmitter...I totally recommend the miaomiao).
Once you have the app all set up it should look something like this.
As you can see at the top tool bar there are 5 icons. The first is the green circle which means you are currently closed looping. If an error occurs the green circle will become red. Also, if the circle is a semi circle that means you are open looping which I will discuss later on.
Next you can see you blood sugar reading. This information is derived from the spike app. Which reads my miaomiao transmitter every 5 minutes.
The third icon shows the current basal changes happening at this current time. As shown in the picture my predicted blood sugar is 6.2 therefore loop has chosen to keep the basal set on my pump. Any basal changes done with your current pump basals as a starting point therefore, its vital in my opinion to have an accurate basal set before you start looping...maybe some basal testing too!
Lastly the 3rd and 4th icon is your pump reservoir and battery. Which is super cool because I get an alert to both my phone and apple watch when either of them go low!
The bottom tool bar has another 5 icons which are pretty handy! The first green one on the left is where I bolus for meals from. Simply inputting my carbs and loop calculates the amount of insulin needed based on your I:C ratio and once i confirm my pump starts bolusing. Pretty cool because I don't even need to touch my pump...just straight off my phone. And my apple watch too!
The following green on and the blur heart are pre set targets. The green on is for pre meals...if I want to be at 4.5 before a meal I will press that icon about an hour or two before my meal so loop can target my blood sugars to my desired setting. The blue heart is a similar idea but for exercise.
The orange double triangles in between them is a bolus option that doesn't include carbohydrates. So if I am correcting or over riding my pump by giving additional insulin.
So how does loop help exactly? the picture above you can see under insulin delivery...each block is a basal increase or decrease that loop adjusted my pump too throughout the day as it aims to keep me in my set target range. Loop adjusts basals in U/H (units per hour) rather than percentages
The picture on the left at the top tool bar you can see that there was a current basal decrease of -0.0625u per hour to prevent me from dipping too low. Loop adjusts if needed as it gets a new blood sugar reading every 5 minutes from my transmitter.
While being closed loop is awesome, a few situations seem to work better when i'm not looping.
When the circle is no longer fully closed that means you are in open looping mode. As you can see that while on open loop the app won't change your pump basal setting however, it will still show you its recommendation
I go to open loop when I override my pump which probably happens more times than i'd like to admit. The reason for this is because loop starts calculating I will be very low so it starts suspending my basal which defeats the purpose to my rage bolus.
Another reason, however I haven't experienced it often is when loop causes my blood sugars to become a yo-yo, going high than low than high than low...you get the point. Not Fun! This happens because the pump suspension causes the spike than a correction causes you to crash back down which makes loop suspend basal again and so on.Going off closed loop allows you to break the cycle so you can fall into range and than go back to closed loop.
I've been looping for about a month and I think its been great! so here is my take on it with some pictures to back me up.
Definitely been in much better range over all with great over all stats! Now loop might've worked against me over the fact that i get even more anxious than before when I go high...just because since I started looping how high I go has decreased quite a bit. It also definitely reduced the amount of lows I have, although if I stop myself from overriding it would be better for sure
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| A Week Of Looping Stats |
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| A Day Of Looping Targets: 4-7.5 |
Interesting
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