# Closed loop pumps



## trophywench (Mar 1, 2015)

Yesterday someone posted a comment on another thread that the Libre CGM was no substitute for a closed loop pump because it (the Libre) measured interstitial fluid, not blood.

Can't find the thread (and the one who posted it is no longer a member LOL) but as far as I'm aware just the same as every CGM known to man, a closed loop pump would be no different.

At least I've never seen anything that suggests closed loop would measure veinous blood.

Am I correct ?


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## Northerner (Mar 1, 2015)

That is my understanding, and that the interstitial fluid readings would be compensated for using the famous 'algorithm'


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## Redkite (Mar 1, 2015)

All CGMs measure interstitial fluid, but the Libre is inferior to the others because it doesn't automatically feed the data back to a receiving device (the user has to manually swipe it when he/she remembers).  The closed loop requires automated data sending and automated actions based on that data.  Currently the new Medtronic pump (640G) used with enlite sensors is the nearest anyone's got to a closed loop being on the market.  This pump will suspend insulin delivery if your BG trends predict a hypo.


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## Pumper_Sue (Mar 1, 2015)

I've been chatting to someone who is doing the trials for the closed loop and dexi is used as nearest comparison. Not to sure but haven't dex bought out a new programme for their cgm that gets as close as close can be to actual blood sugar readings. I seem to remember reading somewhere that the Americans can download it to their dex receivers.


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## Redkite (Mar 1, 2015)

Pumper_Sue said:


> I've been chatting to someone who is doing the trials for the closed loop and dexi is used as nearest comparison. Not to sure but haven't dex bought out a new programme for their cgm that gets as close as close can be to actual blood sugar readings. I seem to remember reading somewhere that the Americans can download it to their dex receivers.


The dex doesn't talk to the pump though.  You can see your BG readings but they don't automatically "make" your pump do anything.  The Medtronic suspends insulin for a low or a predicted low.  The closed loop will be able to give extra insulin for a high.


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## trophywench (Mar 1, 2015)

Well I can accept the Libre being inferior LOL, after all is does only cost 'over £100' compared to 'over £1,000'.

When we win the lottery, well obviously!

But there again do I really want another cannula - with any of them - when I'm quickly running out of sites .....


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## Pumper_Sue (Mar 1, 2015)

Redkite said:


> The dex doesn't talk to the pump though.  You can see your BG readings but they don't automatically "make" your pump do anything.  The Medtronic suspends insulin for a low or a predicted low.  The closed loop will be able to give extra insulin for a high.



Yes it does on the closed loop pump that's being trialled


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## HOBIE (Mar 1, 2015)

Medtronic HAVE one !  The Libre is brilliant gadget but not work hand in hand with a pump but gives lots of info on bg.


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## Redkite (Mar 1, 2015)

Pumper_Sue said:


> Yes it does on the closed loop pump that's being trialled



Yes I know that Sue, but we were talking about things that are available to patients NOW! 

And Trophywench, the Libre is cheaper to buy the initial startup pack, but after that the sensors are a pretty similar price - I pay £55 per enlite.


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## Amberzak (Mar 2, 2015)

I was using the libre. It came out way too easily. It got dislodged when I was don't execise (using the Xbox kenect). 

I don't know what pump I'm going to have but I'm nervous about a closed loop system. What if the CGM gets a fault and the pump thinks the sugars are high so stops giving insulin?


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## Redkite (Mar 2, 2015)

Amberzak said:


> I was using the libre. It came out way too easily. It got dislodged when I was don't execise (using the Xbox kenect).
> 
> I don't know what pump I'm going to have but I'm nervous about a closed loop system. What if the CGM gets a fault and the pump thinks the sugars are high so stops giving insulin?



Amberzak, don't worry , there are NO closed loop pumps on the market at the moment, and although there are some trials going on, these are a long way from being licensed for use.  The ONLY pump that interferes in any way with insulin delivery is the Medtronic (Veo and 640G), and it ONLY suspends insulin if your sugar levels are low, AND this feature is OPTIONAL - the user can turn off the "low suspend" function if they want to.  At the end of the day, even with a CGM, you still need to do a few fingerprick tests across the day to make sure the CGM is tracking accurately.  Be positive, you're going to love your pump, whichever one you have! 

Re the Libre, there's a Facebook group for users of this, and several people have reported the Libre coming unstuck, in which case they have phoned Abbott and received a free replacement, so I imagine your hospital should be able to do the same thing on your behalf if you let them know what's happened. x


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## Amberzak (Mar 2, 2015)

Thanks redkite. 

I meant to say the pump thinks your sugars are low when they are high. Oops. Lol. 

I'm waiting to hear front consultant. I emailed him on Saturday. I might phone the clinic if I don't hear by 10.30 though. I actually feel nervous.


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