OpenAPS

Last updated
Original author(s) Dana Lewis, Scott Leibrand, Ben West
Initial release2015;9 years ago (2015)
Stable release
0.7.0 / 10 November 2019;5 years ago (2019-11-10)
Preview release
0.7.1 / 13 May 2019;5 years ago (2019-05-13)
Repository github.com/openaps
Operating system Cross platform
Available in JavaScript, Python
Type Medical software
License MIT License
Website www.openaps.org

The Open Artificial Pancreas System (OpenAPS) project is a free and open-source project that aims to make basic artificial pancreas system (APS) technology available to everyone. [1] The OpenAPS project was designed with the idea of quickly getting the APS technology to more people using a direct approach, rather than waiting for clinical trials to be completed and regulatory approval to be granted. [1]

Contents

History

Dana Lewis at linux.conf.au in 2019 Dana Lewis at linux.conf.au.jpg
Dana Lewis at linux.conf.au in 2019

OpenAPS traces its origin to 2013, when Dana M. Lewis and Scott Leibrand became aware of privately shared software created by John Costik. This software (which also led to development of the Nightscout project) enabled access and transfer of continuous glucose monitor (CGM) data to cloud computing infrastructure. Lewis, a Type 1 Diabetes patient, was dissatisfied with her commercial device: the device's alarm for hypoglycemic status (which can be life-threatening, if untreated) was too quiet to wake Dana up while sleeping. [2] To address this, Lewis and Leibrand extended the CGM-in-the-cloud software to create a custom high volume alarm. After this initial project, they then used the same CGM-in-the-cloud software to create the Do-It-Yourself Pancreas System (DIYPS) software, which provided a decision assist system for insulin delivery.

This decision automation was able to become a "closed loop" with the help of an open source decoding-carelink project created by Ben West to communicate with Medtronic insulin pumps, enabling data retrieval and issuance of insulin-dosing commands to pumps that support it. [3] With this update, the DIYPS system became "OpenAPS".

Lewis has since presented the OpenAPS at conferences, [4] [5] and has been profiled in various news articles. [2] [6] [7]

Software

The OpenAPS software can run on a small computer such as a Raspberry Pi or Intel Edison and automates an insulin pump's insulin delivery to keep blood glucose in a target range. [2] It does this by monitoring CGM data, algorithmically determining when insulin doses should occur, and issuing commands to the insulin pump to deliver these doses. OpenAPS is a subset of a broader "CGM in the Cloud" social movement; this includes the Nightscout project, which allows CGM users access to their blood sugar data in real time by putting the data in the cloud. [2] [8] As of July 2022 the OpenAPS project knew of over 2,720 people worldwide with various types of DIY closed loop implementations, for over 62 million real-world testing hours. [9]

Regulatory concerns

As with the Nightscout project more generally and as a non-commercial open source project, OpenAPS has not been subject to regulation; this has raised some regulatory concerns, particularly since each user builds their own implementation of the system. [1] [10]

This has also raised some ethical concerns by regulators and researchers. [11] The OpenAPS project emphasizes a "use at your own risk" approach, with the following disclaimer:

[T]he ultimate answer to "is it safe" will be something each individual decides for themselves.

Commercial alternatives

In September 2016, subsequent to the development of OpenAPS, the US FDA released its first approval for an automated insulin delivery device for type 1 diabetes, for Medtronic's MiniMed 670G hybrid closed-loop system. [12]

Related Research Articles

<span class="mw-page-title-main">Insulin pump</span> Medical device to administer insulin

An insulin pump is a medical device used for the administration of insulin in the treatment of diabetes mellitus, also known as continuous subcutaneous insulin therapy. The device configuration may vary depending on design. A traditional pump includes:

<span class="mw-page-title-main">Blood glucose monitoring</span> Use of a glucose monitor for testing the concentration of glucose in the blood

Blood glucose monitoring is the use of a glucose meter for testing the concentration of glucose in the blood (glycemia). Particularly important in diabetes management, a blood glucose test is typically performed by piercing the skin to draw blood, then applying the blood to a chemically active disposable 'test-strip'. The other main option is continuous glucose monitoring (CGM). Different manufacturers use different technology, but most systems measure an electrical characteristic and use this to determine the glucose level in the blood. Skin-prick methods measure capillary blood glucose, whereas CGM correlates interstitial fluid glucose level to blood glucose level. Measurements may occur after fasting or at random nonfasting intervals, each of which informs diagnosis or monitoring in different ways.

<span class="mw-page-title-main">Medtronic</span> Irish tax-registered medical device company

Medtronic plc is an American-Irish medical device company. The company's operational and executive headquarters are in Minneapolis, Minnesota, and its legal headquarters are in Ireland due to its acquisition of Irish-based Covidien in 2015. While it primarily operates in the United States, it operates in more than 150 countries and employs over 90,000 people. It develops and manufactures healthcare technologies and therapies. It is one of the biggest medical tech companies in the world and is currently the largest medical device company in the world by revenue.

Breakthrough T1D is a type 1 diabetes (T1D) research and advocacy organization.

<span class="mw-page-title-main">Automated insulin delivery system</span>

Automated insulin delivery systems are automated systems designed to assist people with insulin-requiring diabetes, by automatically adjusting insulin delivery in response to blood glucose levels. Currently available systems can only deliver a single hormone—insulin. Other systems currently in development aim to improve on current systems by adding one or more additional hormones that can be delivered as needed, providing something closer to the endocrine functionality of the pancreas.

<span class="mw-page-title-main">Diabetes management software</span>

Diabetes Management Software refers to software tools that run on personal computers and personal digital assistants to help persons with Type 1 and Type 2 diabetes manage the data associated with:

<span class="mw-page-title-main">Insulin (medication)</span> Use of insulin protein and analogs as medical treatment

As a medication, insulin is any pharmaceutical preparation of the protein hormone insulin that is used to treat high blood glucose. Such conditions include type 1 diabetes, type 2 diabetes, gestational diabetes, and complications of diabetes such as diabetic ketoacidosis and hyperosmolar hyperglycemic states. Insulin is also used along with glucose to treat hyperkalemia. Typically it is given by injection under the skin, but some forms may also be used by injection into a vein or muscle. There are various types of insulin, suitable for various time spans. The types are often all called insulin in the broad sense, although in a more precise sense, insulin is identical to the naturally occurring molecule whereas insulin analogues have slightly different molecules that allow for modified time of action. It is on the World Health Organization's List of Essential Medicines. In 2022, it was the 192nd most commonly prescribed medication in the United States, with more than 2 million prescriptions.

<span class="mw-page-title-main">Minimed Paradigm</span> Insulin pumps

MiniMed Paradigm is a series of insulin pumps manufactured by Medtronic for patients with diabetes mellitus. The pump operates with a single AAA battery and uses a piston-plunger pump to infuse a programmed amount of insulin into the patient through a length of tubing. The Paradigm uses a one-way wireless radio frequency link to receive blood sugar measurements from select glucose meters. The Paradigm RT series adds the ability to receive data from a mated continuous blood-glucose monitor. Although the pump can use these measurements to assist in calculating a dose of insulin, no actual change in insulin delivery occurs without manual user-intervention.

DexCom, Inc. is a company that develops, manufactures, produces, and distributes continuous glucose monitoring (CGM) systems for diabetes management. It operates internationally with headquarters in San Diego, California; and has manufacturing facilities in Mesa, Arizona; Batu Kawan, Malaysia; and Athenry, Ireland.

Glucommander is a computer-directed method of inpatient glucose management.

International Diabetes Center at Park Nicollet (IDC) is a center for diabetes care, research and education located in Minneapolis, Minnesota, United States. The center provides clinical, motivational and educational services for people with diabetes. It is part of HealthPartners Institute.

Tandem Diabetes Care, Inc. is an American medical device manufacturer based in San Diego, California. The company develops medical technologies for the treatment of diabetes and specifically insulin infusion therapy.

Bigfoot Biomedical Inc. is a medical technology start-up headquartered in Milpitas, California, founded by a team of people with personal connections to type 1 and type 2 diabetes.

Insulin degludec/liraglutide, sold under the brand name Xultophy, is a fixed-dose combination medication for the treatment of adults with type 2 diabetes to improve glycemic control in combination with diet and exercise. It contains insulin degludec and liraglutide. It is administered by subcutaneous injection.

Nightscout is a free and open-source project, and associated social movement, that enables accessing and working with continuous glucose monitor (CGM) data. Nightscout software aims to give users access to their real time blood sugar data by putting this data in the cloud. In addition to browser-based data visualization, Nightscout can also be used to review data from a phone or smartwatch, or to remotely monitor CGM data for individuals with type 1 diabetes. Associated with Nightscout software is a broader "CGM in the Cloud" social movement, supporting individuals seeking to access and use realtime CGM data through commercial and DIY approaches.

<span class="mw-page-title-main">Continuous glucose monitor</span> Blood glucose monitoring device

A continuous glucose monitor (CGM) is a device used for monitoring blood glucose on a continual basis instead of monitoring glucose levels periodically by drawing a drop of blood from a finger. This is known as continuous glucose monitoring. CGMs are used by people who treat their diabetes with insulin, for example people with type 1 diabetes, type 2 diabetes, or other types of diabetes, such as gestational diabetes.

<span class="mw-page-title-main">Open Insulin Project</span> Project to develop an open source protocol for producing insulin

The Open Insulin Project is a community of researchers and advocates working to develop an open-source protocol for producing insulin that is affordable, has transparent pricing, and is community-owned.

Tidepool is a nonprofit company founded in 2013 which makes open-source tools to help people better manage diabetes. The company works together with Medtronic to create an interoperable automated insulin pump system.

Robin Koops is a Dutch mechanical engineer, designer and inventor. He is known for developing an artificial pancreas.

References

  1. 1 2 3 "Home page - What is OpenAPS - FAQ". openaps.org. OpenAPS. Retrieved 23 July 2017.
  2. 1 2 3 4 Martin, Lisa (31 March 2017). "OpenAPS Offers Open Source Tools for Diabetes Management". Make: DIY Projects and Ideas for Makers.
  3. www.github.com/bewest/decoding-carelink
  4. www.frontiersconference.org/speakers/dana-lewis
  5. "Dana Lewis". 16 May 2017.
  6. Rebecca Heilweil (June 15, 2017). "This Woman Designed - And Texts - Her Own Pancreas". Forbes. Retrieved 2017-07-25.
  7. Lee Roop (May 23, 2017). "Alabamian with diabetes built her own artificial pancreas, gives away plan for free". AL.com. Retrieved 2017-07-25.
  8. Sparling, Kerri (14 August 2021) [first published 12 September 2014]. "CGM in the Cloud: The How, Why, and Why Not of Remote CGM Watching". diaTribe.
  9. "Outcomes". OpenAPS. 5 July 2022.
  10. Lee, Joyce M.; Hirschfield, Emily; Wedding, James (2016-04-12). "A Patient-Designed Do-It-Yourself Mobile Technology System for Diabetes: Promise and Challenges for a New Era in Medicine". JAMA. 315 (14): 1447–8. doi:10.1001/jama.2016.1903. PMID   27115262 . Retrieved 2017-05-05.
  11. Farrington, Conor (May 2017). "Hacking diabetes: DIY artificial pancreas systems". The Lancet Diabetes & Endocrinology. 5 (5): 332. doi:10.1016/S2213-8587(16)30397-7. PMID   27913173. the danger with OpenAPS is that some despairing parent with limited technical knowledge will build things incorrectly, with untoward consequences for their offspring.
  12. "FDA approves first automated insulin delivery device for type 1 diabetes | FDA". FDA. 28 September 2016. Retrieved 26 July 2017.

See also