164 lines
11 KiB
Markdown
164 lines
11 KiB
Markdown
**This software is part of a DIY solution and is not a product, but
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requires YOU to read, learn and understand the system and how to use it.
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It is not something that does all your diabetes management for you, but
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allows you to improve your diabetes and quality of life significantly
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if you're willing to put in the time required.
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You alone are responsible for what you do with it.**
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Hardware requirements:
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- A Roche Accu-Chek Combo (any firmware, they all work)
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- A Smartpix or Realtyme device together with the 360 Configuration
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Software to configure the pump.
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Roche sends out Smartpix devices and the configuration software
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free of charge to their customers upon request.
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- A compatible phone: An Android phone with a phone running LineageOS 14.1 (formerly CyanogenMod) or Android 8.1 (Oreo)
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- To build AndroidAPS with Combo support you need the latest Android Studio 3 version
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Limitations:
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- Extended bolus and multiwave bolus are not supported.
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- Only one basal profile is supported.
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- Setting a basal profile other than 1 on the pump, or delivering extended boluses or multiwave
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boluses from the pump interferes with TBRs and forces the loop into low-suspend only mode for 6 hours
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as the the loop can't run safely under those conditions.
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- It's currently not possible to set the time and date on the pump, so daylight saving times
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changes have to be performed manually.
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- There's a bug in the pump's firmware that's triggered when "too much" communication happens
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with the pump. Specifically, this issue occurs when going from just issuing commands to the pump
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to reading the pump's data and history. For that reason, a minimal amount of data is read from
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the pump.
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The bug might still rarely occur and causes the pump to not accept any connection
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unless a button is physically pressed on the pump (make sure the 'pump unreachable' alert is enabled
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so you'll get an alarm if the bug occurs.
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Therefore, the pump's reservoir level is not read and the pump status information uploaded to Nightscout
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shows fake numbers of 150 (above low threshold - which can be configured via the configuration
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tool), 8 (below low threshold, triggers NS alarm since < 10) and 0 if the reservoir is empty.
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Furthermore, no history (from the My Data menu) is read unless absolutely required.
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Reading all pump data can be forced through the Combo tab, to import
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events that happened solely on the pump, but that code has been tested less, might cause duplicates and may
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trigger the bug, so it's strongly recommended to stick to the usage scenario of controlling the
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pump solely through AAPS.
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Checking history, reservoir level etc on the pump causes no issues but should be avoided
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when the Bluetooth icon is displayed on the display, indicating that AAPS is communicating with the pump.
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- Currently only basal rates in the range of 0.05 to 10 U/h are supported (this also applies when modifying
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a profile, e.g. when increasing to 200%, the highest basal rate must not exceed 5 U/h since it will be
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doubled. Similarly, when reducing to 50%, the lowest basal rate must be at least 0.10 U/h).
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Setup:
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- Configure pump using 360 config software.
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- Set/leave the menu configuration as "Standard", this will show only the supported
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menus/actions on the pump and hide those which are unsupported (extended/multiwave bolus,
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multiple basal rates), which cause the loop functionality to be restricted when used because
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it's not possible to run the loop in a safe manner when used.
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- Verify the _Quick Info Text_ is set to "QUICK INFO" (without the quotes, found under _Insulin Pump Options_).
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- Set maximum TBR to 500%
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- Disable end of TBR alert
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- Set TBR duration step-size to 15 min
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- Set low cartridge alarm to your liking
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- Enable keylock (can also be set on the pump directly, see usage section on reasoning)
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- Get Android Studio 3 https://developer.android.com/studio/index.html
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- Follow the link http://ruffy.AndroidAPS.org and clone via git (branch `combo-scripter-v2`)
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- Pair the pump using ruffy, if it doesn't work after multiple attempts, switch to the `pairing` branch, pair,
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then switch back the original branch. If the pump is already paired and
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can be controlled via ruffy, installing the above version is sufficient.
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If AAPS is already installed, switch to the MDI plugin to avoid the Combo
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plugin from interfering with ruffy during the pairing process.
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Note that the pairing processing is somewhat fragile (but only has to be done once)
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and may need a few attempts;
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quickly acknowledge prompts and when starting over, remove the pump device
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from the bluetooth settings beforehand.
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When AAPS is using ruffy, the ruffy app can't be used. The easiest way is to just
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reboot the phone after the pairing process and let AAPS start ruffy in the background.
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- Clone AndroidAPS from https://github.com/jotomo/AndroidAPS (branch `combo-scripter-v2`)
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and build AAPS using the instructions in the wiki http://wiki.AndroidAPS.org
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- Before enabling the Combo plugin in AAPS make sure your profile is set up
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correctly and your basal profile is up to date as AAPS will sync the basal profile
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to the pump.
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Usage:
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- Keep in mind that this is not a product, esp. in the beginning the user needs to monitor and understand the system,
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its limitations and how it can fail. It is strongly advised NOT to use this system when the person
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using is not able to fully understand the system.
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- This integration uses the same functionality which the meter provides that comes with the Combo.
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The meter allows to mirror the pump screen and forwards button presses to the pump. The connection
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to the pump and this forwarding is what the ruffy app does. A `scripter` components reads the screen
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and automates inputing boluses, TBRs etc and making sure inputs are processed correctly (that's what
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the scripter-part in the branch name stands for).
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AAPS then interacts with the scripter to apply loop commands and to administer boluses.
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This mode has some restrictions: it's comparatively slow (but well fast enough for what it is used for),
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doesn't support reading history continuously and setting a TBR or giving a bolus causes the pump to
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vibrate.
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- The integration of the Combo with AndroidAPS is designed with the assumption that all inputs are
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made via AndroidAPS. Boluses entered on the pump will NOT be detected by AAPS and may therefore
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result in too much insulin being delivered.
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- The pump's first basal rate profile is read on app start and is updated by AAPS. Manually changing
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the pump's basal rate profile will lead to wrong basals being delivered and is NOT supported.
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- It's recommended to enable key lock on the pump to prevent bolusing from the pump, esp. when the
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pump was used before and quick bolusing was a habit.
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Also, with keylock enabled, accidentally pressing a key will NOT interrupt a running command
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- When a BOLUS/TBR CANCELLED alert starts on the pump during bolusing or setting a TBR, this is
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caused by a disconnect between pump and phone. The app will try to reconnect and confirm the alert
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and then retry the last action (boluses are NOT retried for safety reasons). Therefore,
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such an alarm shall be ignored (cancelling it is not a big issue, but will lead to the currently
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active action to have to wait till the pump's display turns off before it can reconnect to the
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pump). If the pump's alarm continues, the last action might have failed, in which case the user
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needs to confirm the alarm.
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- When a low cartridge or low battery alarm is raised during a bolus, they are confirmed and shown
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as a notification in AAPS. If they occur while no connection is open to the pump, going to the
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combo tab and hitting the Refresh button will take over those alerts by confirming them and
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showing a notification in AAPS.
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- When AAPS fails to confirm a TBR CANCELLED alert, or one is raised for a different reason,
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hitting Refresh in the Combo tab establishes a connection, confirms the alert and shows
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a notification for it in AAPS. This can safely be done, since those alerts are benign - an
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appropriate TBR will be set again during the next loop iteration.
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- For all other alerts raised by the pump: connecting to the pump will show the alert message in
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the Combo tab, e.g. "State: E4: Occlusion" as well as showing a notification on the main screen.
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An error will raise an urgent notification.
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- After pairing, ruffy should not be used directly (AAPS will start in the background as needed),
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since using ruffy at AAPS at the same time is not supported.
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- If AAPS crashes (or is stopped from the debugger) while AAPS and the pump were comunicating (using
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ruffy), it might be necessary to force close ruffy. Restarting AAPS will start ruffy again.
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- Read the documentation on the wiki as well as the docs at https://openaps.org
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- Don't press any buttons on the pump while AAPS communicates with the pump (Bluetooth logo is
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shown on the pump).
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- If the loop requests a running TBR to be cancelled the Combo will set a TBR of 90% or 110%
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for 15 minutes instead. This is because cancelling a TBR causes an alert on the pump which
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causes a lot of vibrations.
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- Due to the bug (which causes the pump to become unreachable when reading history regularly),
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a delivered bolus will NOT be added to treatments when the connection was lost during bolusing
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or when a pump error occurs (e.g. occlusion). This will raise a message (and play an annoying
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sound) and the user will have a create a bolus record via Careportal/NS manually. Currently
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this requires an available NS installation and being online (for a short time). Hopefully
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both of these issues can be resolved in future versions.
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Known issues:
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- Occasionally (every couple of days or so) AAPS might fail to automatically cancel
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a TBR CANCELLED alert the user then needs to deal with (press the refresh button in AAPS
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to transfer the warning to AAPS or confirm the alert on the pump).
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- Similarly, the 'pump unreachable' bug may occur from time to time, which requires confirming
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the alert on the pump to get the pump to accept connections again.
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- Overall the integration seems rather robust, but there are limits to the way the
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pump is controlled and how stable BT is, so there will be minor issues like the above
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from time to time, though they're small compared to what works well.
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- AAPS might be unresponsive for 10-30s or so when starting and calculating sensitivity.
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AAPS might also be unresponsive when doing background work, e.g. after receiving a new
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glucose reading.
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- Since the pump's date & time can't be updated automatically at this time, daylight saving changes
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will cause an alert asking to update the pump clock. A usable workaround should be to disable
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the automatic update of the phone's clock for the night and then enabling it again in the morning
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when also updating the pump.
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Reporting bugs:
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- Note the precise time the problem occurred and describe the circumstances and steps that caused
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the problem
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- Note the Build version (found in the About dialog in the app, when pressing the three dots in the
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upper-right corner).
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- Attach the app's log files, which can be found on the phone in
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_/storage/emulated/0/Android/data/info.nightscout.androidaps/_
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Components/Layers (developers):
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- AndroidAPS
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- ComboPlugin
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- ruffy-spi (RuffyCommands interface to plug in lower layer)
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- Scripting layer (ruffyscripter) / Command layer
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- Driver layer (ruffy)
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