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_Master Your DIY Closed-Loop Insulin Delivery System_

Published on 11 January 2024.
Published on 21 January 2024.

## In this edition (so far):
## In this edition:

* [*Zoom* Sessions](#upcoming-zoom-sessions)
* [Do you have a `Diabuddy`?](#do-you-have-a-diabuddy)
* [`Nightscout` News](#nightscout-news)
* [Frequently Asked Questions](#frequently-asked-questions)
* [Do Not Make a Double Entry](#do-not-make-a-double-entry)
* [Automatic Temp Basal vs Manual Temp Basal](#automatic-temp-basal-vs-manual-temp-basal)
* [Resuming Scheduled Basal](#resuming-scheduled-basal)
* [Searching for Information?](#searching-for-information)
* [Enhanced Customization for Profiles](#enhanced-customization-for-profiles)
* [Always use Automatic Time](#always-use-automatic-time)
* [Helpful Links](#helpful-links)

## Upcoming *Zoom* Sessions

*Zoom* Sessions use this link:

* [https://us06web.zoom.us/j/89085412738?pwd=eXpTN2M5V3M0TEVJQktmVldBTVRYUT09](https://us06web.zoom.us/j/89085412738?pwd=eXpTN2M5V3M0TEVJQktmVldBTVRYUT09)
* [https://us06web.zoom.us/j/89085412738?pwd=eXpTN2M5V3M0TEVJQktmVldBTVRYUT09](https://us06web.zoom.us/j/89085412738?pwd=eXpTN2M5V3M0TEVJQktmVldBTVRYUT09){:target="_blank"}

| Topic | Recorded? | Time | Date |
| - | - | - | - |
| _<span translate="no">Loop and Learn</span>_: Informal Discussion | no | 19:00 UTC | 11 January |
| _<span translate="no">Loop and Learn</span>_: Informal Discussion | no | 19:00 UTC | 8 February |
| _<span translate="no">Loop and Learn</span>_: Informal Discussion | no | 19:00 UTC | 14 March |

This is the first session of this year. The schedule is the second Thursday of each month.
The schedule for 2024 is the second Thursday of each month.

#### Time Zone Converter

Need help figuring out when an event happens in your time zone? Try the [SavvyTime: UTC Converter](https://savvytime.com/converter/utc).
Need help figuring out when an event happens in your time zone? Try the [SavvyTime: UTC Converter](https://savvytime.com/converter/utc){:target="_blank"}.

## Do you have a `Diabuddy`?
## Automatic Temp Basal vs Manual Temp Basal

> Definition: A `Diabuddy` is someone who can help you with your diabetes when you need it.
A [Temporary Basal](https://loopkit.github.io/loopdocs/operation/algorithm/temp-basal/){:target="_blank"} (TB) can be issued by the *Loop* app when in `Closed Loop` mode to regulate insulin delivery every 5 minutes. The *Loop* app determines when to enact a TB and when to return to scheduled basal, using a prediction updated every 5 minutes (or when a new CGM reading is detected), based on user entries and settings. If the user has selected <span>Automatic Bolus</span> <span>Dosing Strategy</span>, then TB are only used to reduce the amount of insulin delivered. The TB automatically issued by the *Loop* app all have a duration of 30 minutes. If no further commands are detected by the pump, at the end of 30 minutes, the pump returns to scheduled basal delivery.

`Diabuddies` are the best! They’re not just friends with diabetes in common, but they offer encouragement and support like few other people can. They can also be supportive by sharing data for safety’s sake, through such apps as [Nightscout](https://www.loopandlearn.org/nightscout/), [Loop Follow](https://www.loopandlearn.org/loop-follow/), [Gluroo](https://gluroo.com/), [Happy Bob](https://happybob.app/), [Dexcom Follow](https://www.dexcom.com/en-us/faqs/how-do-i-share-my-dexcom-g6-glucose-data-followers), or [Sugarmate](https://www.sugarmate.io/features). Some of our `diabuddies` have helped each other by calling to check in during nighttime low alarms and have even managed Loop remotely during surgeries! We urge you to get a `diabuddy` and make a plan for when help is needed.
A [Manual Temporary Basal](https://loopkit.github.io/loopdocs/loop-3/omnipod/#manual-temp-basal){:target="_blank"} (MTB) is a user-selected setting that effectively opens the loop and keeps insulin delivery steady at a user-defined rate for the user-defined duration (from 30 minutes up to 12 hours). If you use a Medtronic pump, you need to disable `closed-loop`, set MTB on your Medtronic pump and restore normal operation when done.

Think ahead: If you have a medical procedure that may leave you confused or sleepy - make sure you have someone who will check that your pump is working properly afterward. Or you could make plans to add a long-acting insulin option. Be safe - [avoid DKA](https://healthonline.washington.edu/sites/default/files/record_pdfs/Insulin-Pumps-Diabetic-Ketoacidosis-(DKA).pdf).
### Resuming Scheduled Basal

## `Nightscout` News
**Under normal operation**: The *Loop* app always sets a 30 minute TB. If the next prediction needs the same TB as the previous one, the TB is not modified to save the load on pump batteries. After 20 minutes, if the same TB is still required, then a new one is issued.

There are several services that provide hosting of your `Nightscout` site as listed in the [`Nightscout` Documentation](https://nightscout.github.io/nightscout/new_user/#vendors-comparison-table).
**If connection with the phone is lost**: The pump resumes scheduled basal between 10 and 30 minutes later, depending on when the last TB was initiated.

This news refers to two specific hosting services.
## Searching for Information?

* [NS10be](https://ns.10be.de/en/index.html) is offering a [25% discount](https://www.facebook.com/10be.de/posts/pfbid0r8gqqD6X1mWjR237g2vLbQCjoyo61hkpAkMh3z5rvSmBV7HJF8f14vKtv3SJcm77l) off their `Nightscout` hosting services, including all active subscriptions, until March 1, 2024
* For new users, use the discount code `2024BE`
* For existing users, no action needed, your discount is automatically applied
We all have occasional troubles finding information through searches, but we urge you to use this valuable tool before asking questions on your favorite social media site. You may find lots more information than you realized is available.

* For those who use [Nightscout Pro](https://nightscout.pro/en_us/) as their hosting service, there is a new app to make it easier to adjust your own configuration variables
* See the free app in the [App Store](https://apps.apple.com/vn/app/nightscout-pro/id6475240448)
* This is only useful for active subscribers
A major exception is when you are too flustered or hurried to search- there’s usually someone online ready to help. In that situation, ask and then search! And -of course- always be sure to seek help from emergency services first in an emergency!

## Frequently Asked Questions
* The [*LoopDocs*](https://loopkit.github.io/loopdocs/){:target="_blank"} website has a search bar in upper right
* The [*Loop and Learn*](https://www.loopandlearn.org){:target="_blank"} website has a magnifying glass icon in upper right
* The [*Loop and Learn Facebook*](https://www.facebook.com/groups/LOOPandLEARN){:target="_blank"} group has a magnifying glass icon in upper right

Some recent frequently asked questions on Facebook involve the use of the *Loop* app in what I’ll call “non-conventional” (for a closed-loop system) ways. Here is helpful info from the *LoopDocs* website on these two topics:
## Enhanced Customization for Profiles

* [Open&nbsp;<span translate="no">Loop</span>](https://loopkit.github.io/loopdocs/operation/loop/open-loop/)
* We recommend running the *Loop* app with `Closed-Loop` disabled when just starting out
* After settings are dialed in and you’re up and running, we recommend running the *Loop* app with `Closed-Loop` enabled for almost every situation
* [Extended Bolus](https://loopkit.github.io/loopdocs/operation/loop/open-loop/#extended-bolus)
* This is not a feature provided by the *Loop* app, however an explanation of how to simulate one in Open mode is provided at that link
* This involves use of `Manual Temporary Basal` feature - see the warning below
* WARNING: When a [`Manual Temporary Basal`](https://loopkit.github.io/loopdocs/loop-3/omnipod/#manual-temp-basal) is enacted, the *Loop* app will not change insulin delivery **for any reason** until the `Manual Temporary Basal` duration ends or is manually turned off
* This means that, even if your glucose values are dropping, when you have a `Manual Temporary Basal` set to deliver insulin, the *Loop* app will not override your instructions
* This also means that if your glucose values are high and your need insulin delivered, when you have a `Manual Temporary Basal` set to 0 U/hr, the *Loop* app will not start delivering insulin
> Updated to add support for current Profile name in `Nightscout` and `Loop Follow`. Note - only the current profile is uploaded. Other profiles are stored only on the `Looper's` phone.
## Do Not Make a Double Entry
We’re excited to bring you the latest updates to the Profiles Customization for the *Loop* app. At the same time, the *Loop Follow* app (v2.1.4) supports displaying that profile name if you use the customization.

Beware the double Carb Entry, which could result in 2X the bolus you need! Please see this section of the *LoopDocs* website for information on [meal entries](https://loopkit.github.io/loopdocs/operation/features/carbs/#meal-entry_1).
New features for the customization include:

If you hit `Save and Bolus` and the bolus does not go through for any reason, those carbs are still saved in the *Loop* app. Do not enter them again.
* **Nightscout Display**: Your current active profile is now visible in Nightscout!
* **Bug Fix for mmol/L Users**: We’ve squashed a bug where the app could mistakenly detect a profile change and suggest an update!

New feature for the *Loop Follow* app (v2.1.4):

* `Loop Follow`: The user can select Profile as a display option to see the active profile used by the *Loop* app. If the profile customization is not applied to the *Loop* app, this simply shows `Default`.

Get the Updates:

* The enhanced [Profile Save & Load](https://www.loopandlearn.org/loop-features-in-development/#pr-2002){:target="_blank"} customization for the *Loop* app is available for both `main` and `dev` branches. You must rebuild to get the update using either [Browser Build](https://www.loopandlearn.org/custom-code/#github-intro){:target="_blank"} or [Mac Build](https://www.loopandlearn.org/custom-code/#customization-select){:target="_blank"}.

* [`Loop Follow`](https://www.loopandlearn.org/loop-follow/#build-lf){:target="_blank"}: You need to build version 2.1.4 (released 18 January 2024) or newer to get the Profile display support.

We’re committed to continually improving your experience with `Loop` and `Loop Follow`. Your feedback is invaluable, so please share your experiences and suggestions with us.

## Always use Automatic Time

If you turn off automatic time and manually change the time while using the *Loop* app, you might get into a situation where the app crashes repeatedly. You can turn off permissions for `Loop` in Apple Health and might be able to operate, but this limits long-term storage on your phone. Set Screen Time, with a PIN, which will disable your -or your child’s- ability to change the phone’s time. If the *Loop* app continues to crash because of a time change, even after you restore time to automatic, you will have to delete Loop off the phone completely, rebuild a fresh version, and repopulate all settings, overrides and options to resolve the issue.

!!! question "Why would someone change the time on their phone?"
One reason is to get more gaming time. So if you or your T1D child use the *Loop* phone for gaming, do yourself a favor and don’t change the time! Lock out the options with: iOS Settings, Screen Time, Lock Screen Time Settings and apply a PIN. This disables the ability for anything other than automatic time.

To check that your phone is on automatic time, go to iOS Settings, General, Date & Time.

## Helpful Links

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_Master Your DIY Closed-Loop Insulin Delivery System_

Published on 11 January 2024.
Published on 21 January 2024.

## In this edition (so far):
## In this edition:

* [*Zoom* Sessions](#upcoming-zoom-sessions)
* [Automatic Temp Basal vs Manual Temp Basal](#automatic-temp-basal-vs-manual-temp-basal)
Expand All @@ -25,15 +25,15 @@ Published on 11 January 2024.
| _<span translate="no">Loop and Learn</span>_: Informal Discussion | no | 19:00 UTC | 8 February |
| _<span translate="no">Loop and Learn</span>_: Informal Discussion | no | 19:00 UTC | 14 March |

This is the first session of this year. The schedule is the second Thursday of each month.
The schedule for 2024 is the second Thursday of each month.

#### Time Zone Converter

Need help figuring out when an event happens in your time zone? Try the [SavvyTime: UTC Converter](https://savvytime.com/converter/utc){:target="_blank"}.

## Automatic Temp Basal vs Manual Temp Basal

A [Temporary Basal](https://loopkit.github.io/loopdocs/operation/algorithm/temp-basal/){:target="_blank"} (TB) can be issued by the *Loop* app when in `Closed Loop` mode to regulate insulin delivery every 5 minutes. The *Loop* app determines when to enact a TB and when to return to scheduled basal, using a prediction updated every 5 minutes (or when a new CGM reading is detected), based on user entries and settings. If the user has selected <span>Automatic Bolus</span> <span>Dosing Strategy</span>, then TB are only used to reduce the amount of insulin delivered. The TB automatically issued by the *Loop* app all have a duration of 30 minutes. If not further commands are detected by the pump, at the end of 30 minutes, the pump returns to scheduled basal deliver.
A [Temporary Basal](https://loopkit.github.io/loopdocs/operation/algorithm/temp-basal/){:target="_blank"} (TB) can be issued by the *Loop* app when in `Closed Loop` mode to regulate insulin delivery every 5 minutes. The *Loop* app determines when to enact a TB and when to return to scheduled basal, using a prediction updated every 5 minutes (or when a new CGM reading is detected), based on user entries and settings. If the user has selected <span>Automatic Bolus</span> <span>Dosing Strategy</span>, then TB are only used to reduce the amount of insulin delivered. The TB automatically issued by the *Loop* app all have a duration of 30 minutes. If no further commands are detected by the pump, at the end of 30 minutes, the pump returns to scheduled basal delivery.

A [Manual Temporary Basal](https://loopkit.github.io/loopdocs/loop-3/omnipod/#manual-temp-basal){:target="_blank"} (MTB) is a user-selected setting that effectively opens the loop and keeps insulin delivery steady at a user-defined rate for the user-defined duration (from 30 minutes up to 12 hours). If you use a Medtronic pump, you need to disable `closed-loop`, set MTB on your Medtronic pump and restore normal operation when done.

Expand All @@ -51,7 +51,7 @@ A major exception is when you are too flustered or hurried to search- there’s

* The [*LoopDocs*](https://loopkit.github.io/loopdocs/){:target="_blank"} website has a search bar in upper right
* The [*Loop and Learn*](https://www.loopandlearn.org){:target="_blank"} website has a magnifying glass icon in upper right
* The [*Loop and Learn Facebook*](https://www.loopandlearn.org){:target="_blank"} group has a magnifying glass icon in upper right
* The [*Loop and Learn Facebook*](https://www.facebook.com/groups/LOOPandLEARN){:target="_blank"} group has a magnifying glass icon in upper right

## Enhanced Customization for Profiles

Expand All @@ -74,11 +74,11 @@ Get the Updates:

* [`Loop Follow`](https://www.loopandlearn.org/loop-follow/#build-lf){:target="_blank"}: You need to build version 2.1.4 (released 18 January 2024) or newer to get the Profile display support.

We’re committed to continually improving Profiles in `Loop` and `Loop Follow`. Your feedback is invaluable, so please share your experiences and suggestions with us.
We’re committed to continually improving your experience with `Loop` and `Loop Follow`. Your feedback is invaluable, so please share your experiences and suggestions with us.

## Always use Automatic Time

If you turn off automatic time and manually change the time while using the *Loop* app, you might get into a situation where the app crashes repeatedly. You can turn off permissions for `Loop` in Apple Health and might be able to operate, but this limits long-term storage on your phone. Set Screen Time, with a PIN, which will disable your -or your child’s- ability to change the phone’s time. If the *Loop* app crashes because of a time change, you will have to delete Loop off the phone completely, rebuild a fresh version, and repopulate all info to resolve the issue.
If you turn off automatic time and manually change the time while using the *Loop* app, you might get into a situation where the app crashes repeatedly. You can turn off permissions for `Loop` in Apple Health and might be able to operate, but this limits long-term storage on your phone. Set Screen Time, with a PIN, which will disable your -or your child’s- ability to change the phone’s time. If the *Loop* app continues to crash because of a time change, even after you restore time to automatic, you will have to delete Loop off the phone completely, rebuild a fresh version, and repopulate all settings, overrides and options to resolve the issue.

!!! question "Why would someone change the time on their phone?"
One reason is to get more gaming time. So if you or your T1D child use the *Loop* phone for gaming, do yourself a favor and don’t change the time! Lock out the options with: iOS Settings, Screen Time, Lock Screen Time Settings and apply a PIN. This disables the ability for anything other than automatic time.
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