I am not sure that link will work. So, I try to copy as much of dialog as I can. Of cause with mine comments. I cannot post on Medscape. I am not MD so, they rejected me. There are some other who can post under name 'other profeccionals'. Usually many reader like myself post under this name. I cannot post under this name. I had been rejected to post comments. So, I read the publication and post my opinion in mine blog.
On first look it is great to have Artificial Pancreas. Really, why not? After reading what is this and how does it works, I am sure it is not good for me, and I never will use it.
DIY is do-it-yourself (DIY) closed-loop insulin pump systems.
As Lal, MD presented:
Insulin delivery system? I use Flex Pens to inject insulin. It is very convenient and 100% reliable. I can use different size of needles, 8mm or 5mm. These needles are very tiny, shorp, and have special cover to reduce pain of injection. Also if one takes insulin which was Rx by MD then needles will be paid. I take a new needle for every injection I do take. Needles are very tine. They can be bend easily. So, I use needle second time only if I run out of needles, and I do not have health plan to pay for them.
to monitor blood sugars on a continuous basis?
Of cause it is good to know what is the level of sugar right now in my blood. What for? Just think about, it is day after day, 24/7 monitoring system. How one going to use this info? I am just simple diabetic type 2, nothing too fancy. What I need to know the level of sugar in my blood at any time I need it to know. I use simple glucose strips and glucose meter. It is reliable, and it give me the idea how treatment go on. I do not want to carry on my body this monitor 24/7. Also remember after a few days there will be small wound on the side. This spot can easy get infected. I will not use this monitoring even for my child, so inconvenient it is. Most important, there is no need in it.
And the third is something to control that insulin delivery—which used to be the person but now can be turned over to machines and algorithms, in some aspects.
Very interesting point. Our MD cannot say what dose of insulin to inject every time we push needle into our body. For that reason, it is pretended that some machine can do the job? What machine and how this machine do it?
Folks have come together and have figured out ways of reading data from their sensors and ways of controlling their pumps. They are writing code in order to help command the system and execute this artificial pancreas-type control that we talk about. This code is freely available.
At first, any pump is all the time under control of diabetic or someone care team. Second, what code can be written and used to dose of insulin, time, type of insulin, and life style of diabetic? It is fake in the first place, why?
When we think about diabetes it is looks like insulin and level the sugar in blood are linear dependency. That it is simple line:
if sugar is 200mg/dl then 10 units of Novolog and 20 units of Lantus;
if sugar is 300 then it is 20 units of Novolog and 40 units of Lantus, and so so on. (Just for instance only)
The problem is only one, sugar in blood and dose of insulin inn injectionare not in direct dependency. No one can send code to machine, and in modern time there is no one machine which can do this job.
really, why there are no authorities to cut this crap in professional med journal? Is this really true that Dr.Topol proved this article? Shame of you, Dr. Topol!!!!!!!!!!!!!!!!!!!
DIY Artificial Pancreas: Patients Aren't Waiting for Us
by Jay H. Shubrook, DO; Rayhan A. Lal, MD
https://www.medscape.com/viewarticle/902714?nlid=125525_1521&src=WNL_mdplsfeat_181016_mscpedit_wir&uac=164666HZ&spon=17&impID=1771030&faf=1#vp_2
On first look it is great to have Artificial Pancreas. Really, why not? After reading what is this and how does it works, I am sure it is not good for me, and I never will use it.
Lal: First and foremost, this is not approved by the US Food and Drug Administration, so you have to discuss risks and benefits with the patient and familyWOW! Why this DIY device was not approve by ADA? As long as I do know ADA approve all what they paid for. Still, it is important to know, DIY device was not approved by ADA, so diabetic and family must pay for this device out of pocket. No one health plan will pay for medicine or device which was not approve by ADA. System work on Insulin delivery. Insulin at first is very expensive. Also it is medicine we may have only by Rx of MD. No one MD will Rx this device if it is honest person. Personally I do not like to be served by person who is not honest. If MD will be couched MD can lost license. It is crap from the first step we take. As I re-posted today, it is our choice to take this step or not. It is our free will. But we have to know, this system is illegal and cannot be used as proper treatment for diabetics type 2 or type 1.
DIY is do-it-yourself (DIY) closed-loop insulin pump systems.
As Lal, MD presented:
Lal: That is a great question. Whenever we talk about artificial pancreas systems, in general we're talking about three components. The first is a reliable insulin delivery system. The second is a way to monitor blood sugars on a continuous basis. And the third is something to control that insulin delivery—which used to be the person but now can be turned over to machines and algorithms, in some aspects. That third aspect [requires] a process controller that can decide: "For this stream of glucose data, how am I going to affect insulin delivery?"Let take a look what do we have:
Insulin delivery system? I use Flex Pens to inject insulin. It is very convenient and 100% reliable. I can use different size of needles, 8mm or 5mm. These needles are very tiny, shorp, and have special cover to reduce pain of injection. Also if one takes insulin which was Rx by MD then needles will be paid. I take a new needle for every injection I do take. Needles are very tine. They can be bend easily. So, I use needle second time only if I run out of needles, and I do not have health plan to pay for them.
to monitor blood sugars on a continuous basis?
Of cause it is good to know what is the level of sugar right now in my blood. What for? Just think about, it is day after day, 24/7 monitoring system. How one going to use this info? I am just simple diabetic type 2, nothing too fancy. What I need to know the level of sugar in my blood at any time I need it to know. I use simple glucose strips and glucose meter. It is reliable, and it give me the idea how treatment go on. I do not want to carry on my body this monitor 24/7. Also remember after a few days there will be small wound on the side. This spot can easy get infected. I will not use this monitoring even for my child, so inconvenient it is. Most important, there is no need in it.
And the third is something to control that insulin delivery—which used to be the person but now can be turned over to machines and algorithms, in some aspects.
Very interesting point. Our MD cannot say what dose of insulin to inject every time we push needle into our body. For that reason, it is pretended that some machine can do the job? What machine and how this machine do it?
Folks have come together and have figured out ways of reading data from their sensors and ways of controlling their pumps. They are writing code in order to help command the system and execute this artificial pancreas-type control that we talk about. This code is freely available.
At first, any pump is all the time under control of diabetic or someone care team. Second, what code can be written and used to dose of insulin, time, type of insulin, and life style of diabetic? It is fake in the first place, why?
When we think about diabetes it is looks like insulin and level the sugar in blood are linear dependency. That it is simple line:
if sugar is 200mg/dl then 10 units of Novolog and 20 units of Lantus;
if sugar is 300 then it is 20 units of Novolog and 40 units of Lantus, and so so on. (Just for instance only)
The problem is only one, sugar in blood and dose of insulin inn injectionare not in direct dependency. No one can send code to machine, and in modern time there is no one machine which can do this job.
Shubrook: For primary care clinicians, this topic might not be very familiar. If a patient came in and asked me about this, what are two or three things you think a primary care physician should know?Do not ask Lal, MD. Ask me. Go for it. It is your Free Will. The same as you sale it her and now. But if I am your patient and you pretend to reach me with this illegal crab, I will report you to authorities.
really, why there are no authorities to cut this crap in professional med journal? Is this really true that Dr.Topol proved this article? Shame of you, Dr. Topol!!!!!!!!!!!!!!!!!!!
DIY Artificial Pancreas: Patients Aren't Waiting for Us
by Jay H. Shubrook, DO; Rayhan A. Lal, MD
https://www.medscape.com/viewarticle/902714?nlid=125525_1521&src=WNL_mdplsfeat_181016_mscpedit_wir&uac=164666HZ&spon=17&impID=1771030&faf=1#vp_2
via Ravenvoron
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