Glycaemic control in individuals with type 1 diabetes using an open source artificial pancreas system (OpenAPS)

Abstract

Open source artificial pancreas systems (OpenAPS) have gained considerable interest in the diabetes community. We analyzed continuous glucose monitoring (CGM) records of 80 OpenAPS users with type 1 diabetes (T1D). A total of 19 495 days (53.4 years) of CGM records were available. Mean glucose was 7.6 ± 1.1 mmol/L, time in range 3.9–10 mmol/L was 77.5 ± 10.5%, <3.9 mmol/L was 4.3 ± 3.6%, <3.0 mmol/L was 1.3 ± 1.9%, >10 mmol/L was 18.2 ± 11.0% and > 13.9 mmol/L was 4.1 ± 4.0%, respectively. In 34 OpenAPS users, additional CGM records were obtained while using sensor‐augmented pump therapy (SAP). After changing from SAP to OpenAPS, lower mean glucose (−0.6 ± 0.7; P < 0.0001), lower estimated HbA1c (−0.4 ± 0.5%; P < 0.0001), higher time in range 3.9–10 mmol/L (+9.3 ± 9.5%; P < 0.0001), less time < 3.0 mmol/L (−0.7 ± 2.2%; P = 0.0171), lower coefficient of variation (−2.4 ± 5.8; P = 0.0198) and lower mean of daily differences (−0.6 ± 0.9 mmol/L; P = 0.0005) was observed. Glycaemic control using OpenAPS was comparable with results of more rigorously developed and tested AP systems. However, OpenAPS was used by a highly selective, motivated and technology‐adept cohort, despite not being approved for the treatment of individuals with T1D.

Use of a do-it-yourself artificial pancreas system is associated with better glucose management and higher quality of life among adults with type 1 diabetes

“…This is in line with previous studies evaluating DIYAPS. [10][11][12][14][15][16][17][18] Our findings collectively underpin the robustness of DIYAPS as a seemingly effective approach among T1D patients irrespective of baseline HbA1c.…”

The Do-It-Yourself Artificial Pancreas: A Comprehensive Review

“…In consonance with these findings, a UK observational study concluded that OpenAPS initiation The authors also observed that a change from sensor-augmented pump (SAP) therapy to OpenAPS in 34 of the users significantly reduced the mean glucose, estimated HbA1c, time in hypo and hyperglycemia, and accretion in TIR. In short, this study conclusively proved that OpenAPS systems are as competent as the other meticulously developed and tested devices [31,32]. Koutsovasilis et al reported that the use of OpenAPS systems in patients with T1D (n = 24) resulted in appreciable glycemic control in terms of HbA1c, fasting blood glucose (FBG), pre-meal, post-meal, and before bedtime glucose, less or no hypoglycemic events, and reduction in daily BG fluctuations [33].…”

The DIY artificial pancreas system: an ethical dilemma for doctors

“…You must give patients the information they want or need about… c. options for treating or managing the condition… f. whether a proposed investigation or treatment is part of a research programme or is an innovative treatment designed specifically for their benefit… l. any treatments that you believe have greater potential benefit for the patient than those you or your organisation can offer. [15] Although not provided directly by the doctor or the National Health Service (NHS), DIY APS are precisely 'an innovative treatment designed specifically for their benefit', and based on observational data [16,17], a treatment that offers 'greater potential benefit for the patient'. Taking these two points together, it could thus be argued that doctors should discuss DIY APS with people living with type 1 diabetes.…”