Objectives

AndroidAPS tiene una serie de Objetivos que deben completarse para guiarlo a través de las características y configuraciones de lazo cerrado de manera segura. Estos, aseguran que ha configurado correctamente todo lo detallado en las secciones anteriores, y que comprende lo que está haciendo su sistema y por qué, de modo que pueda confiar en él.

If you are upgrading phones then you can export your settings to keep your progress through the objectives. No solo se guardará su progreso a través de los objetivos, sino también su configuración de seguridad, como el máximo bolo, etc. Si no exporta e importa su configuración, deberá volver a comenzar los objetivos desde el principio. It is a good idea to backup your settings frequently just in case.

Objective 1: Setting up visualization and monitoring, analysing basals and ratios

  • Select the right blood glucose source for your setup. See BG Source for more information.
  • Select the right Pump in ConfigBuilder (select Virtual Pump if you are using a pump model with no AndroidAPS driver for looping) to ensure your pump status can communicate with AndroidAPS.
  • If using DanaR pump then ensure you have followed DanaR Insulin Pump instructions to ensure the link between pump and AndroidAPS.
  • Follow instructions in Nightscout page to ensure Nightscout can receive and display this data.
  • Note that URL in NSClient must be WITHOUT /api/v1/ at the end - see NSClient settings in Preferences.

You may need to wait for the next blood glucose reading to arrive before AndroidAPS will recognise it.

Objective 2: Learn how to control AndroidAPS

  • Perform several actions in AndroidAPS as described in this objective.

  • Click on the orange text “Not completed yet” to access the to-dos.

  • Links will be provided to guide you in case you are not familiar with a specific action yet.

    Screenshot objective 2

Objective 3: Prove your knowledge

  • Pass a multiple-choice exam testing your AndroidAPS knowledge.

  • Click on the orange text “Not completed yet” to access the page with the question and answering optons.

  • Links will be provided to guide you in case you are unsure abouit the correct answers yet.

    Screenshot objective 3

Objective 4: Starting on an open loop

  • Select Open Loop either from Preferences, or by pressing and holding the Loop button in top left of the home screen.
  • Work through the Preferences to set up for you.
  • Manually enact at least 20 of the temporary basal rate suggestions over a period of 7 days; input them to your pump and confirm in AndroidAPS that you have accepted them. Ensure this data shows in AndroidAPS and Nightscout.
  • Enable temp targets if necessary. Use hypo temp targets to prevent that the system will correct too strong because of a raising blood glucose after a hypo.

Objective 5: Understanding your open loop, including its temp basal recommendations

You will want to set your target higher than usual until you are confident in the calculations and settings. System allows

  • a low target to be a minimum of 4 mmol (72 mg/dl) or maximum of 10 mmol (180 mg/dl)
  • a high target to be a minimum of 5 mmol (90 mg/dl) and maximum of 15 mmol (225 mg/dl)
  • a temporary target as a single value can be anywhere in the range of 4 mmol to 15 mmol (72 mg/dl to 225 mg/dl)

The target is the value that calculations are based on, and not the same as where you aim to keep your blood glucose values within. If your target is very wide (say, 3 or more mmol [50 mg/dl or more] wide), you will often find little AAPS action. This is because blood glucose is eventually predicted to be somewhere in that wide range and therefore not many fluctuating temporary basal rates are suggested.

You may want to experiment with adjusting your targets to be a closer together range (say, 1 or less mmol [20 mg/dl or less] wide), and observe how the behavior of your system changes as a result.

You can view a wider range (green lines) on the graph for the values you aim to keep your blood glucose within by entering different values in Preferences > Range for Visualisation.

Stop sign

Stop here if you are open looping with a virtual pump - do not click Verify at the end of this objective.

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Objective 6: Starting to close the loop with Low Glucose Suspend

Warning sign

Closed loop will not correct high bg values in objective 6 as it is limited to low glucose suspend. High bg values have to be corrected manually by you!

  • Select Closed Loop either from Preferences or by pressing and holding the Open Loop button in the top left of the home screen.
  • Set your target range slightly higher than you usually aim for, just to be safe.
  • Watch how temporary basals are active by viewing the blue basal text on the homescreen or the blue basal render on the homescreen graph.
  • Ensure your settings have supported AndroidAPS to avoid having to treat a low glucose over a period of 5 days. If you are still having frequent or severe low glucose episodes then consider refining your DIA, basal, ISF and carb ratios.

The system will override your maxIOB settings to zero, which means if blood glucose is dropping it can reduce basal for you, but if blood glucose is rising then it will only increase basal if the IOB is negative (from a previous Low Glucose Suspend), otherwise basal rates will remain the same as your selected profile. You may temporarily experience spikes following treated hypos without the ability to increase basal on the rebound.

Objective 7: Tuning the closed loop, raising max IOB above 0 and gradually lowering BG targets

  • Raise your ‘Maximum total IOB OpenAPS can’t go over’ (in OpenAPS called ‘max-iob’) above 0 over a period of 1 day, the default recommendation is “average mealbolus + 3x max daily basal”(for SMB algorithm) or “3x max daily basal” (for older AMA algorithm) but you should slowly work up to this until you know your settings work for you (max daily basal = the maximum hourly value in any time segment of the day).

    This recommendation should be seen as a starting point. If you set to the 3x and you are seeing moves that push you to hard and fast then lower that number. If you are very resistant raise it a very little at a time.

    max daily basal
  • Once confident on how much IOB suits your looping patterns then reduce your targets to your desired level.

Objective 8: Adjust basals and ratios if needed, and then enable autosens

  • You can use autotune as a one off to check your basals remain accurate, or do a traditional basal test.
  • Enable autosens over a period of 7 days and watch the white line on the homescreen graph show how your sensitivity to insulin may be rising or falling as a result of exercise or hormones etc, and keep an eye in the OpenAPS report tab how AndroidAPS is adjusting the basals and/or targets accordingly.

Don’t forget to record your looping in `this form <http://bit.ly/nowlooping>`_ logging AndroidAPS as your type of DIY loop software, if you have not already done so.

Objective 9: Enabling additional oref0 features for daytime use, such as advanced meal assist (AMA)

  • Now you should feel confident with how AndroidAPS works and what settings reflect your diabetes best
  • Then over a period of 28 days you can try additional features that automate even more of the work for you such as the advanced meal assist

Objective 10: Enabling additional oref1 features for daytime use, such as super micro bolus (SMB)

  • You must read the SMB chapter in this wiki and chapter oref1 in openAPSdocs to understand how SMB works, especially what’s the idea behind zero-temping.
  • Then you ought to rise maxIOB to get SMBs working fine. maxIOB now includes all IOB, not just added basal. That is, if given a bolus of 8 U for a meal and maxIOB is 7 U, no SMBs will be delivered until IOB drops below 7 U. A good start is maxIOB = average mealbolus + 3x max daily basal (max daily basal = the maximum hourly value in any time segment of the day - see objective 7 for an illustration)
  • min_5m_carbimpact default in absorption settings has changed from 3 to 8 going from AMA to SMB. If you are upgrading from AMA to SMB, you have to change it manualy