Looping is the next big thing in the diabetes world at the moment. But even for me, whilst I work in science and am used to some of this mumbo-jumbo, it was difficult to dive in. You literally get dropped in the deep-end and I missed a looping-for-dummies explanation. Hopefully this article can help out those people looking to grasp some of the basics, written not just with those who want to start looping in mind but also as a potential resource for family members, school nurses, colleagues or anybody interested in learning a little bit more.
To get everyone on the same page let’s start with a couple of sentences on type 1 diabetes mellitus (T1DM). With T1DM the pancreas no longer produces insulin. We need insulin to extract glucose/energy from the foods that we eat. So with T1DM we need to give ourselves insulin for meals, keeping in mind any factors which could influence insulin absorption like hormones, sickness, sports etc. Basically this turns into a huge guessing game, and with all these guestimates we try to keep our blood sugars under control. It is a time intensive process requiring a lot of dedication, energy and hard work. And we never get a moment off. Until loop.
Loop does not cure us, although loop sounds fantastic it is not for everyone! Don’t get me wrong, it makes life so much easier, HOWEVER, you need to understand all of the single components that loop takes into account. More on this later in another post. Let me first explain what loop is.
Let’s start talking about Tesla. For our wedding vehicle my husband chose a Tesla. At first I didn’t realize how cool it was. Yet once we were driving it was amazing. We were on the freeway and if you put out the blinker to move a lane, the Tesla will do the rest itself. It will check if there are any cars near you or in the lane you want to move to. It will steer itself into the lane. It is crazy to just sit there and watch the car do all the work. You do always have to keep an eye on the car. It can only assess situations where nothing unexpected happens. If all of a sudden a deer crosses the road, or a car in front of you slams onto the brakes with no warning, you need to intervene. It can brake slowly but it cannot make an emergency stop.
Now let’s go back to loop. It works similar to the Tesla in the sense that it can help improve our blood sugars but if unexpected things happen we need to help out. So although it doesn’t mean you don’t have to ever think about your blood sugars again with loop, it does immensely reduce the amount of time you spend on it and it can, if you understand how to change your settings accordingly, greatly improve the amount of time your blood sugars are in range. Now who doesn’t want that?
Here is another example. With the Tesla, or any car with cruise control, you set a speed at which you want to drive. If you go down a hill the car will automatically break a little so the set speed is not passed saving you from paying a ticket. If you drive up a hill the car will add some power to maintain the set speed so you don’t have angry cars honking behind you because you are going too slow.
Now with loop, there are many variables which it uses to predict future blood glucose. But it all boils down to this; if Loop sees your blood sugars are dropping too fast, it will actually shut down your insulin delivery. It will turn itself back on once you are steady again. If your sugars start to rise, loop can increase your insulin rates to try and prevent you from going high. Most times it will catch a high or low before it happens, as long as it goes relatively steady. Which of course is not always the case with diabetes. In my experience though, even if I have to intervene myself it will at the very least help my lows be less dramatic because the insulin will have been decreased for a while and my highs less high because loop will have been trying to bring me down already.
Once again, Loop is not a cure. Nor does it mean you don’t ever have to think about your diabetes again. Yet for me it has meant that most nights I can sleep through the night because loop keeps me stable. It has given me back so much energy because most days I only need to think about my diabetes at mealtimes or before sports. And I don’t have to check my blood sugars every 10 minutes to see if I need to make adjustments. Loop does this for me! Even if loop would not work during the day, just the fact that I can have some well rested and deep sleep, has made all the difference!