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American Diabetes Month 2015: Day 23 - Closed Loop systems

Day 23, I wanted to continue the discussion on the closed loop systems.

What is a closed loop system?

A closed loop system is a complete system that takes feedback from a sensor of sorts and automatically respond to that feedback.  Some examples of closed loop systems include: self-driving cars, airplane autopilot, cruise control, vacation e-mail message auto-reply, etc.  While for each of these some of the sensors are pre-programmed things (autopilot, cruise control, email auto-reply) the ones that are not pre-programmed plans are still very much in development.

Why don't you want a closed loop system?

Of the above examples of closed loop systems, the only one that really comes close to what MIGHT be necessary to convince me is self-driving cars.  Look at all of the money that has been invested in that by the big-name companies like Google, Ford, Tesla, etc.  I look at the amount of money that's been spent on that and figure it'll take as much, if not more to get the sensors and the loop to get to a point where I MIGHT feel comfortable with using it on my body.  The problem with closed loop systems and the current sensors is the issue that I've explained previously.  The sensor data is almost entirely useless for the first day because of the calibration steps and the lag between blood glucose and subcutaneous glucose.

What has currently been done?

Currently, there are very few systems that will close the loop between any action being taken and any sensor data being gathered.  The only current system that was being used was to stop the insulin pump in the event of a low blood glucose from the CGM.  One of the issues I have with this is that stopping the insulin pump when a low blood sugar is reached, it's likely too late for anything to fix that situation, just not make it any worse.  Right now, the current state of closed loop systems are similar to what's available for my current car, which notifies me when I'm crossing a lane without signaling the lane change, or if there is someone in my blind spot.  My car doesn't take any actions, much like my insulin pump doesn't take any action to halt the delivery of or deliver any additional insulin.  But there is one insulin pump (that I know of) that currently does.  I've said before that I want more clinical trials, and research before I use it myself, and will continue to hold that philosophy.  I just haven't seen enough progress being made in the items that I use to constitute trusting a closed loop system just yet.


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