[mhovd]

The risk to benefits ratio of introducing a language model to interpret so clear signals is nowhere near justified.

Monitoring and analytics is important, but it is a solved problem. A language model will only be able to hallucinate about the relationship between meals and glycemic response. At best it does no harm, at worst it can directly misinform.

[pimeys]

Yep. The oref1 algorithm is amazing and proven to make diabetic's quality of life better, AND SAFE. I don't understand why would you need to add AI to that mix.

But I will check this algo out. Maybe it has some interesting bits.

[wg0]

Thanks for calling out!

We're even yet debating and trying to understand what impact AI has on software engineering and quality let alone putting AI into something that's directly linked to a human's well being.

[nonameiguess]

That's just risk/benefit to the user. As the developer, I'd be concerned that publicly distributing and marketing this, even with a GPL "no warranty" license and even free to the user, is illegal.

[pimeys]

You can distribute the source code for research purposes legally at least here in Germany. That's how AndroidAPS is even possible.

[AnthonBerg]

My experience is completely the opposite, of using LLMs to pattern match and cast diagnostic nets.

Is your perspective based on, say, opinionated principle?, or experience?

The benefits are enormous.

The risks; What risks? No diabetic with baseline adult competence is going to drive their insulin-delivery vehicle off a cliff because some app said so.

[pferde]

I think you're being too optimistic about your fellow humans' judgement. "Death by GPS" is a quite common occurrence: https://www.sciencedirect.com/science/article/abs/pii/S13550...

[AnthonBerg]

Type 1 diabetes with the sensors and pump technology that this software being presented here fits to is not Everyman Joe stuff. Someone who can set this up and get this going is already burdened with the kind of analysis that the app can assist with.

[andersonpico]

> No diabetic with baseline adult competence is going to drive their insulin-delivery vehicle off a cliff because some app said so.

if you can't trust this thing then what is it doing? the implication that people that trust this software do not have adult competency is also confusing.

> Is your perspective based on, say, opinionated principle?, or experience?

your perspective is solely based on recent trauma so I don't know if it is more reliable in any capacity

[AnthonBerg]

Don't trust the thing. That's not what it's for.

Don't do as I say. I'm just a rando from the Internet.

Don't do as the author of the posted software does. Don't do what the software tells you either. But the software can certainly build an informative perspective and suggest patterns and movements in an exquisitely complex disease. Managing T1D with a pump is exhausting.

Second, re. "your perspective is solely based on recent trauma so I don't know if it is more reliable in any capacity"

This kind of statement is far beyond anything bounded by the self-respect of a balanced adult. What the fuck, and who are you?

My ex-fiancée almost died in 2020. We lost an unborn child in IVF due to grave neglect on behalf of healthcare who missed the glaringly obvious Type 1 diabetes she had; They never once checked her blood sugar. You know what I did? I read the literature. I read medicine, I read molecular biology, I read neuroimmunobiology, I read about the placenta and fetal development.

I stood by my fiancée and carried her by hand back to health. She recovered faster than the endocrinologists expected. Her pregnancy was exemplary, fullly intact placental vitals out to 38.5 weeks. Healthcare is in such a bad state that I was forced to interject and argue coolly and adamantly with doctors on several occasions about potentially severe mistakes they were about to make. EVERY SINGLE TIME when I interceded, it was confirmed correct by a second opinion from a senior doctor.

I don't come here speaking from trauma. I come here speaking from grim and serious and confirmed lived experience of stepping in and caring, without any margin for error. Know how you do that? With extreme humility and the utmost care.

Who are you to speak to me like that; I can tell that you know not at all who I am or what I have been tasked with in this life, because then you would not. talk. to me. this way. Okay?

[consp]

> The risks; What risks? No diabetic with baseline adult competence is going to drive their insulin-delivery vehicle off a cliff because some app said so.

My local physician says otherwise, with respect to facebook posts about dosages. I'm convinced the same applies to LLM generated content with respect to people blindly following the computer.

[AnthonBerg]

I ask for your understanding in that I chose to have "baseline adult competence" highly load-bearing in my comment. This does not include people who have only such poor judgement to guide them that they use Facebook posts as input to managing their T1D pump/sensor-based management.

It is entirely possible to beneficially and safely use software like the that which is the topic of the post.

[pu_pe]

Risks:

Changing parameters on the insulin pump because the LLM said so

Neglecting to seek actual medical advice believing a LLM replaces it

Misunderstanding medical complexity (ie a prescription due to medical history not available to the LLM)

[brookst]

Are those different from the risks of reading about diabetes on Reddit or using Google?

[mexicocitinluez]

> No diabetic with baseline adult competence is going to drive their insulin-delivery vehicle off a cliff because some app said so.

You 1000% don't work with the general public in a tech way.

[AnthonBerg]

"Baseline adult competence" was load-bearing there.

This is not an app for the general public.

[mexicocitinluez]

> This is not an app for the general public.

Can you point me to where it explicitly says that this app is not to be consumed by the general public? Or explain how that could even be enforced?

And my entire point was "baseline adult competence" means very little. Competent in what? Technology? Insulin administration? Both? If they're competent in technology but not insulin administration, than this is obviously a bad idea. If they're competent in insulin administration, but not technology, then why would they use it?

We're not even at the point where we can definitely say it's a good idea to surface this information to actual professionals let alone someone with no clinical experience.

It's a bad idea, period. I work with both clinicians and the general public and the idea that this can be responsibility used by either is a pipe dream that only people who work with neither can believe in.

[AnthonBerg]

This is as dangerous as people talking together on e.g. Facebook groups. I've seen people give flat out dangerous advice, and other people take it.

Nursed someone back to health and went through a T1D pregnancy and certainly had to work with the clinicians during; Desperately: There is use for this software, and no greater need to bury it or unmake it than it is to bury or unmake Facebook groups or other discussion venues.

In fact, software that actually reads literature and presents perspectives actually derived from plausibility from a scientific basis is in many cases a 100% increase of availability of such a perspective. Doctors – from experience – may not offer that. And forum lore rarely does.

Software that actually reaches into literature – which LLMs do – and presents its perspective with the required framing is arguably a strict improvement to the infohazardous environment of a given patient with a difficult condition like T1 diabetes.

And I ask for this discussion's participants' understanding of the sarcastically wry use of "basic adult competence". It was at once arrogant and caring, and put forward… in something as quasi-serious as a HN discussion. I think that's OK.

[mexicocitinluez]

> his is as dangerous as people talking together on e.g. Facebook groups. I've seen people give flat out dangerous advice, and other people take it.

Not even remotely close. A large portion of people in the field still don't understand how LLM's work let alone your grandmother on Facebook. They're apples and oranges.

> There is use for this software, and no greater need to bury it or unmake it than it is to bury or unmake Facebook groups or other discussion venues.

Discussion forums are nothing like an LLM. People don't assume the other person on the forum is magic. Again, these are totally different things that have no correlation with each other. People have been in some form of forum for hundreds of thousands of years. They have no experienced a genie that has ingested the entirety of human knowledge. They're just flat out 2 different things.

And you're experience as a single person doesn't mean that experience is universal. I quite literally work with clinicians and patients every day. Clinicians aren't evne sure how to use these tools (with actual clinical knowledge), but yet we're ready to shoot them out to consumers? It's wild.

Of course there is a need to get better info, but that doesn't then follow that the route of that should be an unregulated, unlicensed LLM.