The first Living with Looping – an event summary!

The idea for “Living with Looping” spawned as more and more people have joined the WeAreNotWaiting community, setting up their own closed loop systems, and regularly asking similar questions of the already looping community.

It was aimed to be a “Read the docs in person” experience, where the most important points within the various pieces of documentation were highlighted and discussed, attempting to explain the “Why” as well as the “How”.

At the end of the day, participants should have been able to better understand why various factors are important, the part they play in looping and what they can do to make changes in those areas. I also hoped that armed with a bit more knowledge, everyone participating would feel more comfortable sharing what they knew!

We had 71 people turn up, of which 66 were adults coming to learn and 5 were kids (some already on loops), there because their parents were.

Of those attending, 26 were not yet looping (but all looking at looping), while the remainder had varying levels of experience, stepping from weeks to years.

We took a few polls on the day, and I thought that it’s worth sharing the responses of the participants, in order to better understand how people who attended looked at the topic.

Firstly, the distribution of participants was heavily skewed towards AndroidAPS (which reflects similarly to the ongoing UK DIY APS User Survey):

Whilst this might seem a high skew to AndroidAPS, it really reflects access to pumps:

Similarly, CGM use and mechanism use was a mixed bag, and reflects some of how CGM funding works in the UK, but potentially also the user base and demography:

There was one Eversense user in the room, that I had not included in the list. Overwhelmingly though, Dexcom was the favoured data source in the room.

In the CGM section we spent 45 minutes discussing CGM, why it was important to have good data from the CGM and some of the nuances between different systems, and how and why care had to be taken. There was a vibrant discussion with many points of view.

DIY looping and CGM – a critical cog in the machine

We then moved on to Settings.

I also ran a couple of polls to see how well people understand the various documentation and what they’ve read. They’re very much indicative, but they do provide insight into what people are learning and reading.

Firstly, a question on DIA settings:

It was heartening to see the majority of people taking advantage of the advice and setting this to a longer period. Those setting three or four hours were the ones who weren’t yet using a loop of some kind.

With this as the starting point, we moved through Duration of Insulin Action, Basal settings, Insulin Sensitivity Factor and Carb Ratio. 

The second question about understanding looked at the language used in discussing settings:

And while there is still some disagreement about what “more aggressive” or “less aggressive” means, for the most part, people take it to mean making the carb value smaller (ie moving from 1u:10g to 1u:5g). 

The intention here was to show the ways you can identify whether these settings are correct by looking at the various glucose and insulin data and then strategies to deal with it.

https://kdisimone.github.io/looptips/settings/settings/

Similarly, with the Mealtimes, Exercise and “Other Things” sections, we were looking to get people to discuss what they did and talk about what’s been identified as best practice, showing people the options available to them as strategies to deal with each of these factors.

Mealtime advice

Exercising with a loop

When a site fails

Managing a high glucose level

Dealing with lows

Hopefully, this insight into the attendees and structure of the event is useful. The presentation is available online through Glisser (but requires providing an email if you want to see it).

If you have any questions, please let me know in the comments!