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Permalink Reply by Jonathan on April 27, 2009 at 8:25am

Excellent points, and probably why the closed loop is decades away. Some other things to consider:

1. Software quality: each of us is different. The algorithms for how our bodies react to a fixed amount of carbs are different for each of us, and they can change for no apparent reason. For a closed loop system to work, it would have to be programmed properly, and the software would need to be able to learn from the reactions our bodies have to carbs and insulin. My endo has told me that the biggest hurdle to the closed loop is that the software is not flexible enough, smart enough or reliable enough to take BG measurements and properly dose them.

2. Going low: the closed loop system also needs a way to treat a low. I've seen a number of suggestions that it has to contain glucagon, too, so that if we go low, the system can inject some glucagon to solve the problem without outside input.

I think Dave is right -- it is all a nice idea, but it is not ready for prime time. That does not mean I think that the biomedical development community should stop trying. I think they just need to be realistic about what they can achieve and whether it will really stand up to testing and commercial use. After all, it needs to be safer than an airplane -- zero tolerance for failure.

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Permalink Reply by Jan on April 27, 2009 at 6:19am

Thanks for posting this. I was not aware the Artificial Pancreas was so close to coming to market! I am a bit leery, though. Relying on the computer in the AP to make all dosing decisions. What if the computer malfunctions? I would prefer the cgms/pump setup with the computer analyzing. Then, hopefully, you could get the analysis from the computer regarding recommended basal/bolus sensitivity changes every morning or evening. I would like an analysis and recommendations that I could then decide whether or not to implement. Now, on Carelink, you can see the data, but you may not be making the proper adjustments or you may omit an adjustment based on your own interpretation of the data. I would like computerized, analytical "suggestions". I do not want the computer automatically "taking over". It is a machine and machines break down. This is exciting, but scary. LOL, I note that they have gone back to the mega sensors:( I

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