Raymond Biesinger

Many diabetics have been eagerly anticipating 2018 as the year when several hybrid closed-loop systems hit the commercial market - thanks in no small part to an open-source biohacking community of people living with the condition.

Often referred to as artificial pancreases, hybrid closed-loop systems are set to change the daily lives of diabetics significantly. Diabetics of all types have varying degrees of pancreatic impairment or failure which prevents their bodies' natural abilities to produce or withhold insulin, which helps to regulate blood glucose levels. To manage their condition, they need to keep track of their blood-sugar levels. This means taking readings throughout the day, projecting the impact of the food they are about to eat or the exercise they're about to engage in, and using this data to determine their need to administer the hormone. It's like having to do calculus before you eat a meal or jump on a bike.


In 2018, several hybrid closed-loop systems will begin to appear on the market. These will measure a user's blood-sugar levels every five minutes or so and supply insulin subcutaneously as appropriate. A large part of the R&D behind them was done in the open-source community. One such group, the Open Artificial Pancreas System project (OpenAPS), has for the past three years been encouraging diabetic biohackers to explore and improve their existing monitoring and insulin-delivery systems. "OpenAPS was able to move quicker due to the lack of regulatory burden on individuals," says Dana Lewis, its founder and creator.

OpenAPS's software and data can be picked up and developed by anyone. One manufacturer, the Massachusetts- based medical-device company Insulet, is working closely with the company. "Insulet has conducted focus groups with the DIY community and has been concerted in its efforts, identifying what data it actually needs to see on the phone screen," says Lewis.

Medtronic Diabetes, based in Watford, also drew on the open-source community to develop a hybrid closed-loop system, which is due to be in full commercial distribution by the start of 2018. "Many stakeholders have helped to advance this field," says Ali Dianaty, Medtronic's vice president of research and development. "Each of them plays an important role in creating awareness and driving the work needed to commercialise this system."

But the arrival of these early systems doesn't spell the end of OpenAPS and the DIY community. Like any first-generation hardware and software systems, there's room to apply the learning from the first release to improve the products over time.

"We've been told that we [already] have more sophisticated algorithms than the upcoming commercial releases," says Lewis. "We're not looking to compete with industry. We want them to leverage all the insights of our community. I expect we'll be doing this for at least another five years."