LinkDay 2 (published 2 December 2020)

What does it cost? Here we’ll talk about “hard costs” and “soft costs”

Tradeoffs to the hard and soft costs:

Once you get Loop built and your settings fine-tuned, you will likely find that you spend less time thinking about Diabetes.

  • Most people who suffer from lots of lows pre-Loop, find that their number of, and severity of, low blood glucose events drops significantly to the point where getting-up 4-5 times a week to deal with a low or stubborn high in the middle of the night almost vanishes.
  • Properly used, Loop can reduce severe low and some types of DKA events, reducing or eliminating the costs of ER visits.
  • A1C and Time in Range (%TIR). Most people see better numbers once they get Loop tuned-in.

The hard costs are easy:

  • Apple Developer License $99/year (you can get around this by using a free Apple Developer account, but this will require you to rebuild every 7 days).
  • RF conversion device, the one we have the most experience with, and has very reliable support is the RileyLink for $150.
  • A spare RadioLink. Sure, it is not absolutely necessary to have a spare RileyLink, OrangeLink or EmaLink, but if you jump in the pool and break yours, do you want to go back to the PDM? Personal decision…
  • iPhone or iPod Touch. The “oldest” version of the iPhone that you can build to changes as Apple updates its iOS, but you should expect you are going to need a new phone around every three years. (A later post will cover compatible phones)
  • Apple computer that will run at least Catalina and has enough space to be able to load Xcode. Some Loopers run the Apple OS on windows-based computers using a Virtual Machine.
  • Compatible pump (there will be a section on this on a future day).
  • Compatible CGM (there will be a section on this on a future day).
  • Apple Watch if you want to be able to bolus from your wrist.

Soft costs are more subjective:

  • Time learning how to loop, reading documents like this one, watching videos, reviewing the questions asked in forums. Many people spend 80 hours or more reading and trying to understand before ever “pulling the trigger” to sign-up for the Apple Developer account and purchase the RileyLink.
  • Time building a NightScout site. To be a successful Looper, you need to be able to fine-tune your settings- a free NightScout site is the best way to do this. Nightscout captures your blood glucose and insulin delivery. It takes most people a couple of hours to set up. (Again, a future post)
  • Time keeping your NightScout site up to date. About once a quarter, you need to spend about a half hour updating the software on the NightScout site.
  • Time understanding your settings and learning how to fine-tune them to work with loop, and keep fine-tuning them as your physiology changes.
    • In the beginning, you can easily spend a half hour a day
      • looking at what Loop is doing
      • understanding how your settings are affecting the algorithm
      • making changes to those settings and documenting them
    • As time goes on, most people probably spend an hour or so a month, spread out
      • looking at their graphs to see if they need to make a change
      • Some people input their settings once and forget it, these people are not looping for a teen with growth spurts
  • Time updating Loop software. In theory, you should be able to load Loop on your phone, run it for a year and forget about it. You will be more successful if you keep up on the software changes and periodically update, either when there is a new feature you want, or when a bug is squashed that might affect your use. The most successful people probably update their Loop two to four times a year. This can take anywhere from an hour to a full day depending upon whether iOS, MacOS, and Xcode versions have changed, and more time if you’re using a VM and your VMWare version also needs to be updated. You should probably expect to spend about 8 hours a year on , but it could be more or it could be less.
  • Troubleshooting time. As with all technology, there will be issues from time to time. You need to be able to follow basic troubleshooting steps and know where to look for answers. It varies, but initially, you can expect to spend a few minutes to an hour a week troubleshooting for the first few months until you get more familiar with the system. In general, most users will have a few common problems like phone battery issues, radio interference etc, that they will learn how to quickly deal with once they have seen the same issue a couple of times.
  • Keeping up with Loop. You need to budget an hour a week to looking at a source of information. Depending on what version of Loop you pick, that could be one of several Facebook pages, or a Telegram feed or Zulipchat, or the announcement page on the Loop and Learn web site
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