[arafa]

I know folks that work on Nightscout and I agree with everything in this post. I find them to be very thoughtful and circumspect about the work (the contributors often have T1D or family with T1D). Besides that, a closed loop system (which as yet is only partially implemented or is still somewhat inconsistent) is a holy grail for a lot of these folks.

Most of them are already well acquainted with manually managing insulin and the existing products and can handle any mishaps for the most part.

[gh02t]

I don't really understand in detail how insulin pumps work, so I want to ask why are there not commercial closed-loop systems available? It seems like an obvious development that pump makers should have implemented a long time ago. Is there a complication that makes it harder than it sounds, or is it something like regulatory concerns or just plain laziness?

[GiorgioG]

Few competitors, no reason to innovate. And they're charging $8-12,000 for a new pump setup. That was our experience 5 years ago with Medtronic. Not a single update in 4 years with our son's 530g pump. With his new pump (from Tandem) we're expecting a pretty big software patch/upgrade later this year. Beta Bionics is working on their artificial pancreas (dual hormone) that should be out next year. So newer/more-nimble players are forcing the bigger companies to start innovating. Having said that, it never comes soon enough ;)

[ZucchiniZe]

I got a chance to try out the beta bionics artificial pancreas in a research trial and it is a truly new innovation in this field, it lifted about 90% of the constant thinking about bolus and blood sugar from me and allowed me to live my life. It truly deserves all the hype that it is getting.

[GiorgioG]

Wow that's great to hear! Was it insulin-only or did it also have glucagon onboard? I know they're working towards releasing the insulin-only version first. I can't wait for the dual-hormone version to become available. It'll allow my wife and I to sleep through the night without worrying that our son won't wake up when he drops too low.

[thecosas]

Sidebar: Tandem's Q1 2019 results came out today and they're doing pretty dang well. http://investor.tandemdiabetes.com/news-releases/news-releas...

Operating margin is still negative, but it's improved tremendously year over year.

[bleair]

In short, real humans and these medical devices are inexact. The device must choose “How much insulin should be dosed?”. Lawsuits argue medical devices should be flawless, so no company will bring out a device that could be pointed out as causing an incorrect amount of drugs being delivered The open source insulin pump and continuous-glucose-monitors as a feedback systems are just incredible BUT they require the user to be very aware of what is easy and reliable and what can be flaky (see all the details about pod screamers - e.g. the pod can’t continue, or drift in cgm data)

[emiliobumachar]

Every time a self-driving car kills one person, it's national headlines for a week, with no shortage of people calling for the people responsible to be jailed. It will be like that the first few times that a commercial closed-loop system kills a person.