Hacked Raspberry Pi turned into artificial pancreas
businessinsider.com
businessinsider.com
New pumps by Medtronic are equipped with an auto-off feature that suspends insulin delivery if the user's blood sugar is below a certain threshold [1], however this is a rear-facing indicator and the patient will still experience a hypoglycemic event.
I assume the next logical steps towards making these systems fully autonomous is to remove the idealogical separation of basal and bolus insulin; instead, the system would register increases and decreases of blood sugar and take systematic steps towards bringing them back into a healthy range - much like a healthy pancreas does, either by increasing or decreasing the amount of insulin being delivered at a given time. That way a patient can eat, exercise, and live a "normal" lifestyle while the pump takes care of delivering the correct amount of insulin.
[1] http://www.medtronicdiabetes.com/products/minimed-530g-diabe...
Even a reduction in the amount of hypo- (and, hyper-) glycemic events would be a big win for patients and educators. I think the quality of care would vastly increase with such systems in place.
Additionally - the human body has systems in place to bring blood sugars back into a safe range when it feels it is in an emergency situation. I do not claim to be an expert on this matter, but it is my understanding that the liver is able to release glycogen into the system to spike blood glucose levels back up if they have fallen low [1]. This is why some diabetic patients may experience high blood sugars in the mornings if they have experienced a hypoglycemic event overnight and slept through it. I don't believe this would be a good solution to depend on, however.
[1]http://www.diabetes.co.uk/body/liver-and-blood-glucose-level...
All diabetics ever have is a rear facing indicator, fortunately it's not really true that you can't predict the future when it comes to blood glucose. The simple equation is `exercise + carbs + current blood glucose level + insulin on board` along with all the attributes that make your body respond to artificial insulin the way it will. The system doesn't really need to predict the future to be a massive improvement on where diabetics already are thanks to slow moving organizations like the FDA. With appropriately cautious buffers around when to shut the insulin pump off a huge majority of diabetics will rarely see a low blood sugar. The technology is here, we just have to summon up the will to move medicine forward.
It may work 95% of the time, but that's not good enough. There's a reason really good medical devices are based on simpler platforms that are more robust.
The extra dollar you spend on those 16bits easily pays for itself in the extra features you often get with modern 32bit micros.
Especially something like this where you might want to do relatively complex maths / algorithms.
e.g. see the stm32 family
This is an interesting personal project, but it is far from how medical devices should be (and are) developed. Where is the risk analysis, for example? Or the FMEA? Was the software developed under ISO 62304? Etc.
There's a lot of activity that happens in a regulated industry that is completely missing here, which is why I see this as a poor example.
They could make the thing a lot more fault tolerant if they set up its fstab to mount the file system read only, and run in memory.
"It is possible for one to live without a pancreas, provided that the person takes insulin for proper regulation of blood glucose concentration and pancreatic enzyme supplements to aid digestion."
There's absolutely nothing simple about surgery when the pancreas is involved.
Intiutively it sounds wrong since I'd image any cancer that comes back after the whipple is coming from left over cancer cells in the pancreas, no?
They were non-technical people. Yet they had an android phone connected to a medical device using a 3d printed bracket and short usb cable. The android phone was reporting to a windows azure instance. Pebble watch polling the azure instance for updated levels.
The sysadmin in me recoiled at the myriad operational deficiencies and potential failure modes. Yet they don't have a better option. I get that the FDA has standards it has to apply, but I imagine that many things they would reject would still be vastly better than this. Is there a term for 'the risks people will take anyway rather than wait for something perfectly safe'. Like if you make wait times at crosswalks too long will more people get killed crossing the street?
It's not a perfect system though as substandard stuff does get through and the barriers to effective entry are so high that only the big well funded companies can afford access - not really sure what you can do about that.
As an alternative in this case, I might suggest, "brake".
> Retard - delay or hold back in terms of progress or development.
"They do put a retard" - here, the word "retard" is used in a noun position. Therefore, it is a noun. Therefore, it must refer (and with an implication of cruel disaparagement) to somebody who is mentally handicapped.
I wonder if they use the same person each time?
Sad thing is, although the software controlling this would undoubtedly have lots of flaws and cause suffering and death, not implementing something also allows people to suffer and die.
Now. Another company makes an automated machine, which kills 1/10000 patients on average, because of software errors. Do you think anyone would ever allow the second machine to be sold, even though it would save 9 persons compared to the manually operated machine? Of course not. If it ever came to light that it killed anyone due to a software error, it would be gone faster from the market than you can spell "liability". Does not matter that in fact it's killing less people on average than any other type of machine - it's just that in our minds software bugs are avoidable so therefore they are not acceptable at all.
Pacemakers have a high risk, yet here we have an automated solution. I think liability alone cannot be the root cause.
Assume one did create the device, and got it to work across a wide patient population with varying diets, disease severity, treatment responsivity, etc., and then (somehow) got approval for it. Existing insulin pumps are already challenging to get reimbursed under insurance, and they have a more straightforward regulatory approval path with lower R&D costs. The super pump would need to be reimbursed for quite a bit more money to justify the increased R&D costs. That is going to be a very hard sell under quality of life improvement alone—clinical data showing an improved patient outcome or decreased long-term healthcare costs is what is needed. You're benchmarking against existing pumps with separate monitors, which sets a high bar.