ESPE Abstracts (2018) 89 P-P1-075

Open Source Artificial Pancreas Systems Used from Bulgarian Children and Young People with Diabetes

Maia Konstantinovaa, Milos Kozakb, Radoslav Radevc, Rositza Pandovad, Hristina Dimovae & Rumen Georgievf,g


aBulgarian National Society for Pediatric Endocrinology, Sofia, Bulgaria; bCreator of AndroidAPS, Prague, Czech Republic; cAssociate of the Association ‘Kulture without Borders’, Sofia, Bulgaria; dPresident of the Association ‘Kulture without Borders’, Sofia, Bulgaria; eAssociate of the Association ‘Kulture without borders’, Varna, Bulgaria; fLocal Insurance Company, Dobrich, Bulgaria; gAssociate of the Association ‘Kulture without borders’, Sofia, Bulgaria


Introduction: The new technologies in diabetology improved not only HbA1c, but also ‘Time in range’, ‘Glycemic variability Index ‘/GVI/, and ‘Patient’s Glycemic Status’ /PGS/. Parents of children and patients with diabetes demonstrated impatience for artificial pancreas systems /APS/. They initially created ‘Nightscout’ platform for remote monitoring of the glucose sensors and then – Do It Youself Open Source Artificial Pancreas Systems (DIY OpenAPS). Currently 3 OpenAPS are mostly used:

• AndroidAPS (Milos Kozak)(using OpenAPS algorithm running on Android phones);

• OpenAPS (Dana Lewis)(the original, for old Medtronic pumps, running on pocket computer);

• Loop (Pete Schwamb)(different algorithm running on iPhone with old Medtronic pumps)

In Bulgaria there are 75 Type 1 diabetes patients, who use Android APS and 3 use Loop. The systems are applied by the patients or parents step-by- step, controled by the creators and the team of ‘Culture without borders’.

Objectives: To share the results for 17 Bulgarian patients with AndroidAPS and Loop, who gave access to their Nightscout data.

Materials and Methods: Data for 15 patients using AndroidAPS and 2 - using Loop are presented. Variation analysis was applied for the data obtained from Nightscout platform for 90 and 30 days.

Results: Average age 13.5 (3.8–39.9) years; Duration of diabetes 7,52 (1.8–28.3) years; APS −3 months to 2.3 years. The average levels and ranges of the indices for diabetes control for both periods are shown in the Table 1: No severe hypoglycemia or DKA were observed. All the patients and parents show satisfaction from the APS.

Discussion: The average values for the glycemic control with DIY OpenAPS show stable results for the examined period. The average time in range above 75% is excellent, while the time in hypoglycemia is comparatively low. GVI and PGS also fall in the desired range for optimal control. The registered ranges in the individual parameters give possibilities for the patients/creators/physicians to puzzle out and upgrade the personal settings.

Table 1
Days%low <4.4 mmol/L%Normal >4.4-<10.0%Hgh >10.0HbA1c% HbA1c Mmol/molGVI (<1.5)PGS (35–100)
305.976.117.966.4346.711.3946.1
0.1–12.665–90.54.1–26.15.1–7.433–571.1–1.5813.9–86.0
907.076.316.36.4446.91.4148
0.1–16.263.6–89.90.2–28.25.1–7.333.0–57.01.1–1.5112.8–72.3

Conclusion: The presented patients on DIY OpenAPS manifest safety of the systems, excellent results of all the parameters for precise control of diabetes, as well as high satisfaction of this treatment options.

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