World Diabetes Day 2015 and Blogaversary 3

Eiffel arrivalIt hardly seems like a month ago since I wrote last year’s WDD2014 and Blogaversary 2 post but now I reflect it feels like a lifetime ago.

Three years on and I’m surprised I’m still blogging, I thought my enthusiasm for this fad would have died out by now and I suppose it has a little as I just don’t seem to write so much these days. In reality the problem is time and I’m not sure that’s going to improve any time soon.

World Diabetes Day for me is about reflecting on what we’ve achieved during the past twelve months whilst looking to the future about we’ll achieve, plus the advancements of medicine and tech which help everyone with Type 1 Diabetes.
(I’m posting this early as I’m away for the weekend.)

Motto for the last year

I can sum up the last 12 months in three easy words: Pay It Forward. I’d like to think this has always been my motto but never so much as it has been recently. It’s important to me, it keeps the world spinning in my eyes, it makes may days brighter and when in (thankfully rare) darker moods it’s the only thing which gets me through the day.
So here goes for a few moments of the previous year, but first how’s Amy been getting on?

Amy’s worst moment with Type 1 – Where’s Jacques?

Quite recently we visited Versailles so it’s apt to think this last year was the best of times, it was the worst of times. Unlike in Dickens’s Tale of Two Cities there’s been no revolution but we’ve certainly had two episodes which came too close to kissing the guilotine for my liking. August was marred by two moments when we just took our eye off the ball and by rights Amy should have gone to hospital to quickly get her out of her nose dive towards diabetoketoacidosis. I don’t feel that proud that I didn’t take her in but we wanted to spare her the trauma, but she was scared, we were all scared and yet the first occurrence really proved what a great team our little family unit is, all pulling together for the good of Amy.
That first near-DKA occurrence was a dark moment for me particularly, I’ve never felt so helpless but at the same time the education everyone in the #DOC has helped me attain meant I knew what was going on.
It turns out I can’t even read this tweet without welling up, it’s raw:
nearDKAtweet
Whilst I got lots of advice from the #DOC it was really only Andy Sherwood who kept me going through this as without WiFi or data I relied on SMS and I thankfully had Andy’s number to hand. Thank you Andy.
Anyway, enough of this dark rubbish, let’s move on.

Pay It Forward – with the Pharmacists and Peer Support

In December last year I got the opportunity to help the next generation of Pharmacists learn what living as a family with Type 1 diabetes meant. I thought it went well but maybe not, I’ve not been asked back.
I’ve continued my role as Peer Supporter for Diabetes UK in a slightly lesser manner than before but still get to help people via email. It’s a vital service but I just couldn’t commit any time to answering the phones anymore.

January: time to say #WeAreNotWaiting

On January 1st, in ‘new start’ mode I pulled the trigger and ordered up the components needed to build xDrip and get Nightscout up and running.
10 days later with it up and running I realeasd my first blog about it: #WeAreNotWaiting thanks to #xDrip – Introduction.
I can’t possibly explain it here so read the above article or any of the several #WeAreNotWaiting posts I’ve done.
The xDrip blog articles went wild, especially in the States and are still used by many to introduce xDrip and Nightscout to newbies. I’m quite proud of that.
My involvement with Nightscout and xDrip moved on a stage when I was asked to be part of a team presenting Nightscout to many families at a conference recently. See the posts here and here or watch the videos of the presentations.
My involvement with Nightscout is contuining at a pace and I hope January’s blog(s) may prove interesting and exciting.

March: the #GBDOC conference

The first ever ‘unconference’ organised by Paul and Midge of TeamBloodGlucose was simply brilliant.
The opportunity to meet with several of my online friends was excellent and meeting Veeny was a highlight for me but the effort Jules put in to be able to attend made her the star of the show for many of us.
Later that evening we would learn that toothpaste is an unsuitable hypo treatment. It’s a shock eh?

April: Amy nails a week in Germany

Amy spent a week in April on a student exchange trip to Germany. Not only did she nail her glucose levels sufficiently to have a great time away – some feat considering the family lived so close to the Haribo outlet shop – but she spoken German all the time, one of the few to do so, and nailed an A in her GCSE which she took two years early.

May: Conferences, Public Speaking and Interviews

May was a big month. First, Amy and I spoke a little at the National Paediatric Team Meeting in Birmingham. A super scary time speaking in front of 200 health care professionals.
Then I had the most wonderful time with Chris, interviewing Dr Stephen Ponder about Sugar Surfing on behalf of Diabetes UK. Dr P is undoubtedly one of the nicest people I’ve ever met.

June and August: cycle, cycle, cycle

In June I undertook the biggest cycle ride of my life, cycling from London to Paris in a self-organised and unsupported trip with friends, raising £600 for INPUTDiabetes. The full self-organised London to Paris trip blog is available here if you fancy doing this yourself.
In August I rode the longest ride of my life, 100 miles, supporting JDRF and raising £430 in the Prudential Ride London Surrey 100.

And finally, some statistics

My blog has never been about statistics however it’s really nice to see them improve. Well I say improve, they’ve rocketed since blogging about Nightscout and xDrip.
In the first year the blog had about 11,000 hits.
In the second a huge increase to 27,000 that year, over 38,000 in total.
In the third, because of xDrip, it’s massively increased to 52,000 hits, and a grand total of over 90,000 hits.
The key thing about these numbers is that people are finding the information that matters, and that’s all that matters.

#PayItForward

Presenting Nightscout at CWD FFL 2015 – the videos

This article contains the three presentation videos recorded at Children with Diabetes Friends for Life 2015 at Windsor on November 1st 2015. They are available on the Nightscout UK YouTube channel individually, or as a playlist.

Introduction

Here’s an uplifting video previewing the Nightscout conferences taking part in the Fall Autumn of 2015.

(Watch on YouTube)

Part One

A moving introduction to Nightscout from Wes and then the ‘What Nightscout Means To Me’ presentations from Kate and Jesus.

(Watch on YouTube)

Part Two

Myself, Tim and Stuart give ‘What Nightscout Means To Me’ presentations. Kate introduces Nightscout web pages, apps and CarePortal, Stuart introduces the advanced options, I introduce the reporting options, then take the mick out of Wes’s Apple Watch a little before reminding everyone that Nightscout is DIY, no-one will do it for you.

(Watch on YouTube)

Nightscout Workshop at CWD FFL 2015

You might like to read the article about the morning’s presentation of Nightscout to families at the CWD FFL 2015 conference if you’ve not already done so.

Afternoon Presentation/Workshop

Nightscout UK teamIt seems the afternoon session was the only one actually listed in the FFL programme so we had more people, about 30, attending.
Like the morning session they were really attentive, most of them knew Nightscout already, they wanted it, they needed it and they thankfully had a lot of questions.

 
First we gave the obligatory warning that Nightscout isn’t an approved thing, it can’t be bought, it’s not something anyone would build for you, you should never make a medical decision based on information shown etc. etc..

After debunking the myth that this was a solution only available to nerdy geeks we showed the routes into Nightscout from a ‘How Do You Get Your CGM In The Cloud‘ article, quickly dismissing some of the USA-centric options like Share and focussing on using a Dexcom receiver, xDrip device or using the uploader for Medtronic CGM (not 640g).
Kate showed the original ‘rig’ where a phone is directly connected to a Dexcom receiver as this is what her family first used, but now they use xDrip.

xdrip circuit
xdrip1xdrip2

I presented the xDrip wiring diagram and hopefully quickly busted the myth that it’s hard to build. For me this was the easiest bit to present as I knew most of the audience just got it, for some the penny dropped during the presentation, for some it just reaffirmed what they already knew and thought.
People were keen to see some model xDrips so I passed my two spares to members of the audience, whilst Tim demonstrated the tiny one in a TicTac box which he wears on a band around his bicep which he prefers to do so he doesn’t forget it.
Jesus talked about the components required to build MMCommander to get CGM data from Enlites (for Medtronic 530 and Veo pumps) into Nightscout, which received a lot of interest from the audience.
In the last slide Kate spoke about the different cloud services which were required for a standard Nightscout installation: Azure, for the web site; MongoLab, where the data is held; GitHub, where the code is for everything.

Workshop session

Nightscout afternoon sessionsAt the start of the workshop session we split into two tables, one for Medtronic with Jesus, one for Dexcom/xDrip with Kate, Tim and myself. Stuart meanwhile helped one of the audience members sort out issues with her set up, she left with it working properly.
I spent most of my time showing the two of the different xDrips I’d built, fielding questions about the components or how to build them or issues I faced.

It’s hard to imagine how the session could have gone any better: people seemed to get the answers they needed; people seemed engaged; many said they would order the components that night and set up Nightscout as soon as possible.
From my point of view we had achieved our goal, that one family walked away from the presentation/workshop having discovered something they could set up to help them. But in this case it wasn’t one, it was probably 20 or 30.

Presenting Nightscout to Families at CWD FFL UK 2015

Nighscout FFL, Kev, what nightscout means

Building a team for Old Blighty

Back in September Wes from the USA based Nightscout Foundation gave me the honour (yep Wes, there’s a ‘u’ in honour 🙂 ) of asking me to join a faculty team they were having at the Children With Diabetes Friends For Life UK conference which took place last weekend. Wes was gathering a team of Nightscout and xDrip users together with the aim of showing families what Nightscout does for us.

Nightscout UK team
Left to right: Stuart, Jesus, Wes, Kate, Kev, Tim

And so the team was formed with me, Wes, along with Stuart and Kate whose kids have Type1, and Tim and Jesus who both have Type 1 themselves. Jesus is somewhat of a God (bet that joke hasn’t been said before eh Jesus?) in the community and flew over from Spain for the weekend.

Then Wes dropped the bombshell, he wanted us to present Nightscout, not just give 1-1 advice and info at a stand. Present! What? Me? “Erm, okay” I said very tentatively. Being on holiday for the Saturday I could sadly only attend the Sunday but the planets aligned as that was the day the presentations were (“Oh great!”).

Panicking about presentation slides

At 5am the alarm sounded.
I present often at work and am somewhat reknowned for having whizzy slides full of colour, animation and more importantly eye-distracting graphics which take the focus off of me, but I had a problem as I would have no time to prepare anything as I was on holiday. So at 5am on the Sunday I woke in panic and managed to cobble stuff together and from there on in I felt relaxed, I had a plan, I had slides, I was ready.

A team as one

Nightscout team, anonymousNone of us had met before but after arriving at Windsor and meeting everyone I felt like this was a team which had been together many times, we were so relaxed together, sharing jokes, poking fun, and just understanding everything each other was talking about.
Our first task was to decide who was doing which bits and I found myself volunteering for a lot more than I thought I would. Perhaps I wasn’t so nervous after all.
Wes posted a photo: we were no longer anonymous.

Morning presentation – What Nightscout means to us

The morning session wasn’t advertised in the programme, just on flyers at our stand so we had less than 20 people there, but that was great for my first foray into public speaking. I’ve always felt that if anything I say or write opens the eyes of just one family then I’ve done my job because I know that family will open the eyes of another.
Due to enthusiastically overrunning our slide timing the session really turned into a What Nightscout Means To Us presentation.

Nightscout, Wes opening speechWes opened the presentation with a heartfelt introduction to Nightscout and what it mean for him, it was very moving, speaking about how his son’s T1 diagnosis at 12 months affected the family.
Kate spoke about how Nightscout “makes the diference” and spoke of how the “glanceability” of her glucose readings on a watch reflects what her driving instructor told her “nothing should ever come as a surprise in your rear view mirror”, she’s aware of what’s happening before it escalates into a difficult to deal with hypo or hyper.
Jesus’s story to me is amazing. He’s a parent but he is the T1 and he developed software for himself to monitor glucose readings. One day he heard John Costik’s Nightscout story and within an hour sent him an email to let him know that Jesus could get readings from Medtronic Veo CGM and could amend it to work with Nightscout. I can’t begin to tell you how moved I was by Jesus’s story of selflessness.
Tim’s story was another good one, speaking how great the community is and how Nightscout has pushed the boundaries and helped Dexcom release Share ahead of its original plan. Having Type 1 for 32 years he had a Dexcom receiver but built an xDrip and is pleased to realise the much better calculation engine than that available in UK Dexcom products, with the added bonus of extended life sensors. (USA has the ‘505’ software and Share but this has not been released in the UK.)
Stuart spoke about how Nightscout lets him know “at a glance whether to react or relax”, which along with Kate’s “glanceability” sum up Nightscout very well for me. With his daughter being 13 she is starting to manage her own diabetes and diabetes allows Stuart and his wife to pull away more and only intervene when required, meaning his daughter finds it less intrusive.

My presentation: BG’s are not as important as Snapchat or 5 Seconds of Summer

Nighscout FFL, Kev talking about watchesWhen my turn to speak arose I felt calm, I just wanted to get my story out there, I was somewhat surprised I wasn’t a bag of nerves.
I spoke about how to a teenager almost nothing was more than important the weekend lie-ins and that Nightscout means I’m not worried about whether she’s too low or too high when her bedroom door is closed till noon.
“BG’s are not as important as Snapchat and 5 Seconds of Summer” was my next line. Amy wants to be a teenager and do teenagery stuff like listening to her music and chatting online with friends, probably about the music they’re listening too…and boys…and boys who are in bands…like 5SOS. I mentioned that whilst cooking I can glance at my watch and decide whether I need to intrude on Amy to ask for an early BG check so we can pre-bolus, or adjust to get her at the lower end of her range before eating. Like Stuart’s daughter this is less intrusive for Amy than before Nightscout.
I explained how I use Nightscout to “nudge” Amy. With my range set from 3.5-14mmol and Amy’s set from 4-9mmol (her choice) I know that she would have had an alarm if over 9 but if she reaches 13 for example it’s probably because she’s not noticed an alarm, so I give her a gentle nudge to do a check or make an adjustment.
My key message though was how Amy’s HbA1c’s had changed through her time with Type 1:
hba1c history

Nightscout and how it works

Nighscout FFL, Kev, nightscout reportingKate went into the basics of Nightscout, the website, the browsers and phones and what appears on the screens and gave an overview of CarePortal. CarePortal is where kids and school carers/nurses can enter information about carbs, insulin and many other things into Nightscout which can then immediately be seen by the parent/carer, which in turn means that worries about Hypers may be negated if the parent can see insulin has been given, meaning in turn no panicky phone calls to school.
Stuart expanded on this talking about the ‘pills’ which appear on the screen and show you values such as Insulin On Board, Carbs On Board, and the Bolus Wizard Preview, which based on settings you’ve entered gives you an idea what sort of action might be required to get the child back in range. Stuart stressed that this is only for an idea of what to do and shouldn’t be used without deciding on whether that action is appropriate or not.
Nighscout FFL, Kev talking about watchesI presented about the reports Nightscout gives, comparing them favourably to Diasend which I rarely use now. One report gives you an estimation of A1c and ours said 6.8% prior to the last clinic when Amy got her 6.7% result.
Just for fun us Pebble watch users decided to do a speed test with Wes and his Apple Watch, to see how quick we could all glance out our kids’ glucose level. It took Wes a fair bit or time.

Finally

Finally, it was lunch time, and as the engaged audience left the room I knew the team had done a good job and we eagerly awaited the afternoon session which would include presenting solutions and a workshop where we could solder some bits or help get people going with their Nightscout solutions.

Dexcom, Nightscout and xDrip – how does it all work together?

NOTE: xDrip used to be called DexDrip so you might find some references to the old name in this article.

 

xDrip Nightscout diagram v5My last three xDrip posts (introduction, components and building) have generated a few questions of which device, phone, cable or application goes where, so I thought I’d create a graphic of how I see it all working (well) together.

Scroll down for the large version of the graphic…don’t try and read that one on the right 🙂

Here’s a key to the graphic to help you see what comes from where:
Dexcom G4 CGM system
The Dexcom G4 continuous glucose monitoring system which Nightscout and xDrip are currently based on.
Nightscout
A full system of interfaces, cables, phones and applications to pull Dexcom glucose values from the Dexcom receiver, upload the data to the Internet and allow remote CGM monitoring via websites, phones, smartwatches. Designed and developed by people within the collective of Diabetes Parents who now front the Nightscout Foundation
xDrip
A do-it-yourself device and applications to retrieve data from the Dexcom CGM, using an independent algorithm to calculate the glucose reading, upload values to the same Internet database as used by Nightscout, to allow remote CGM monitoring. There is also a separate app (Nightwatch) which retrieves information from the Nightscout web site and relays info on to a smart watch. Designed and developed by Stephen Black.
Mongolabs.com
A cloud-based database solution, used to store the CGM readings uploaded by either the Nightscout Uploader application or the xDrip application.
xDrip Nightscout diagram v2
 
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PLEASE READ THIS ADVISORY
a) Never make a medical decision based on a reading from any CGM device, whether certified (eg Dexcom) or not (eg xDrip). Always perform a fingerstick blood glucose check first.
b) xDrip is a DIY product, decide for yourself if you wish to use it. Build it, test it, test it again and use (if you want to) in conjunction with a certified receiver.
c) The fact that it is working for us does not mean it’s right for you.
d) Never build a xDrip for anyone else and never sell one.
e) The blogs are provided for information only. We are not endorsing it for use by others, nor promoting it, just merely publishing our information as well as answering questions from previous blog articles.

A Dummy’s Guide to Building an #xDrip – #WeAreNotWaiting

NOTE: xDrip used to be called DexDrip so you might find some references to the old name in this article.

 

If you don’t know what a xDrip device is take a look at this page.

AdaFruit charger magnifiedI was tickled by someone on Reddit who linked to yesterday’s blog about the components required for a xDrip which was entitled “An “Amateur” builds a module for DexDrip”. So here it is, this amateur’s guide to building an xDrip/DexDrip. (The article actually referred to DexDrip as that what xDrip was called at the time.)

Interested in further posts about this subject? Why not like this blog’s Facebook page and get notified of updates, or click ‘Follow’ using the button at the bottom-right of this page.

PLEASE READ THIS ADVISORY
a) Never make a medical decision based on a reading from any CGM device, whether certified (eg Dexcom) or not (eg xDrip). Always perform a fingerstick blood glucose check first.
b) xDrip is a DIY product, decide for yourself if you wish to use it. Build it, test it, test it again and use (if you want to) in conjunction with a certified receiver.
c) The fact that it is working for us does not mean it’s right for you.
d) Never build a xDrip for anyone else and never sell one.
e) The blogs are provided for information only. We are not endorsing it for use by others, nor promoting it, just merely publishing our information as well as answering questions from previous blog articles.

A baptism of fire heat
Although I received lots of offers of help to solder the components together the guys at work told me I’d have no trouble doing it myself, so I decided to try.
First I ordered the soldering kit (iron, solder, stand, helping hands, solder sucker) from eBay and a practice board to train myself with. The ‘helping hands‘ turned out to be worth their weight in gold.
I soldered my first pin, inspected it and then soldered three more, choosing to solder them right next to each other as it seems that a common problem for amateurs is putting too much solder on. With four pins soldered I tested everything for continuity issues, to make sure no excess solder had spilled on to the adjacent contacts and shorted anything out.

practice board face uppractice board face down
So far, so good.
AdaFruit LiPo charger and batteryAttach LiPo-charger connector to battery
My AdaFruit LiPo-charger came with a connector, my battery came with a connector; they weren’t the same.
First job then was to cut the wires from each and solder the battery wires to the LiPo-charger connector.
NOTE: some people remove the connector terminal on the LiPo-charger and solder directly onto the charger board, I didn’t fancy this as I like to be able to disconnect batteries and swap them easily.
DO NOT connect battery to LiPo-charger.
AdaFruit charger magnifiedSolder wires to AdaFruit charger
The AdaFruit Li-Po battery charger then needed a power (red) and ground (black) wiring up.
For my first try I soldered a four-piece-header-pin to the board and used jumper wires to connect to it, but within a week I removed the header pins & soldered the wires directly onto the PCB.
1. Red wire, solder on to 3.3v (marked as BAT on mine), first on the left as we look at that board. Make sure you don’t solder on to the 5v connector.
2. Black wire, solder on to one of the GND connectors, for ease I chose the 3rd from the left.
WIXEL bluetooth wiresConnect wires for bluetooth module to WIXELWIXEL face down
Prepare four wires (red, black, green, blue) with one female header pin at one end and bare wire for soldering at the other.
1. Black, solder to GND
2. Red, solder to 3V3
3. Blue, solder to P1_6
4. Green, solder to P1_7

Other possible options: The header pin option is the simplest way to connect from WIXEL to HM-10.
The hardest (but not too bad) option is to desolder the HM-10’s header pins, then solder wires with two bare ends onto the WIXEL and to the HM-10.
The middle option is to solder wires with two bare ends, one end onto the WIXEL and one bare end onto the relevant header pin on the HM-10. Whilst this might seem easy I think it’s simpler to desolder the HM-10s header pins as above.

WIXEL and BLEConnecting the HM-10 Bluetooth moduleBLE face down
What you do next depends on what you chose to do on the ‘Connect wires for bluetooth module to WIXEL’ step:
If you soldered wires with female header connector at one end when you did the step above then all you need to do next is to slide the correct colour wire’s connector onto the correct HM-10 pin as per the diagram here.
If you soldered wires with two bare ends and left the header pins on the HM-10 then you need to solder the bare wire ends to the correct HM-10 header pin as per the diagram here. This is tricky to do (for me) but not impossible as I found when I made a second xDrip. I choose to wrap electrical tape around each soldered pin/wire afterwards.
If you soldered wires with two bare ends and removed the HM-10 header pins then just solder the bare ends onto the HM-10 as per the diagram here.
WIXEL power wiresSolder LiPo-charger wires to WIXELWIXEL face down
With the LiPo-charger disconnected from the battery (and micro-USB power) you now need to solder its wires to the WIXEL.
Red, solder to VIN
Black, solder to GND
 
The finished product
Hopefully by the end of it you’ll have something that looks like this:
20150109_205710
Note: the picture shows header pin connections for the AdaFruit Li-Po charger but I’ve now soldered the wires directly to the board, it now has a much smaller footprint.
 
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#WeAreNotWaiting thanks to #xDrip – Introduction

xDrip logo on left, Nightscout logo on right
As you can see xDrip loves Nightscout
NOTE: xDrip used to be called DexDrip so you might find some references to the old name in this article.

 

Okay, I’ll own up, I know I shouldn’t be so excited about this but I am.
This is a game changer, for us and many, many more.
It proved its worth within 24 hours when I saw Amy was hypo whilst sleeping (see below). Amy wouldn’t have woken up and tested her blood glucose for another 4 or 5 hours but by having xDrip working I saw that she needed some glucose tablets to raise her blood glucose levels. 5 minutes later she was back asleep…for four more hours. #Teenagers!

Interested in further posts about this subject? Why not like this blog’s Facebook page and get notified of updates, or click ‘Follow’ using the button at the bottom-right of this page.

PLEASE READ THIS ADVISORY
a) Never make a medical decision based on a reading from any CGM device, whether certified (eg Dexcom) or not (eg xDrip). Always perform a fingerstick blood glucose check first.
b) xDrip is a DIY product, decide for yourself if you wish to use it. Build it, test it, test it again and use (if you want to) in conjunction with a certified receiver.
c) The fact that it is working for us does not mean it’s right for you.
d) Never build a xDrip for anyone else and never sell one.
e) The blogs are provided for information only. We are not endorsing it for use by others, nor promoting it, just merely publishing our information as well as answering questions from previous blog articles.

partially made up xDripSo what is xDrip?
xDrip is a combination of a device and a software application which receives data sent out by a Dexcom G4 CGM transmitter/sensor and displays the glucose readings on an Android phone. The app can also upload it’s data for use by Nightscout, which in turn means glucose readings are available on the internet via a PC/Mac, phone or even a smart watch (Pebble etc.).
xDrip is made up of two things:
1. The first is a do-it-yourself device, made up of four components which you can buy off the Internet and solder together. Total price is about £40 including battery. (That’s a partially made device on the right).
2. The second is the xDrip application which runs on Android phones (4.3+above with Bluetooth Low Energy (BLE) support). The app uses the xDrip device to read the output from a Dexcom CGM (continuous glucose monitor) sensor/transmitter. xDrip links up to existing Nightscout databases. The xDrip app can feed the data to a Nightscout database, which in turn means the data can be accessed via the Internet practically anywhere, using a PC/Mac, laptop, smartphone (Android/IOS/Windows) or better still a SmartWatch.

Wait! What? Nightscout? BLE? CGM? Dexcom? Animas?
Okay, it’s probably a good time to go over some of the common words I’ve used in the article. I’ll presume you’re already aware of insulin, insulin pumps, glucose levels and the world of Smartphones.
Animas – Animas is a company that makes insulin pumps. My daughter Amy has been using one of their pumps – called the Vibe (yeah, yeah, I know!) – since since June 2013. We chose the Animas Vibe specifically because of it’s use of Dexcom’s CGM system, although it turned out to be a whole year before we got the chance to use CGM.
BLE – is a version of the Bluetooth communication protocol which uses a low amount of energy, which means devices can work for longer without charging. Android has built-in support for BLE from version 4.3 onwards.
CGM – Continuous glucose monitor. A device which regularly samples the glucose level of its wearer, sampling the glucose in the interstitial fluid, not the blood. If you’re new to CGM perhaps take a look at this blog of mine: CGM: we’re live with Animas/Dexcom.
CGM-in-the-Cloud – is a term for any CGM which can be connected to a web site to allow for remote monitoring of someone’s glucose levels. It’s pretty big in USA, not so much over in Europe. A big player in this is Nightscout (see below).
Dexcom – Dexcom is one of many manufacturers of CGM systems. We use Dexcom because it’s linked with Amy’s Animas Vibe pump, if we’d got a Medtronic pump we’d use their Enlite CGM system. One benefit of Dexcom’s CGM appears to be that the sensors last longer – which is a big thing for us (who pay for CGM ourselves) as it lowers the total cost of using CGM. For the record I don’t believe Dexcom is any better than the new Medtronic Enlites.
Nightscout – Nightscout is “an open source, DIY project that allows real time access to a Dexcom G4 CGM from web browsers via smartphones, computers, tablets, and the Pebble smartwatch. The goal of the project is to allow remote monitoring of the T1D’s glucose level using existing monitoring devices.” In short Nightscout and the people behind it are awesome.

Who should we thank for xDrip?
Not me that’s for sure.
xDrip is the brainchild of Stephen Black, who was recently diagnosed with Type 1 Diabetes. With the help from others in the CGM-in-the-Cloud community Stephen has designed the xDrip device and written the software.
I think he deserves a big round of applause.

So how does it work?
SmartWatch
  • Dexcom sensor reads glucose level
  • Dexcom transmitter sends out data from sensor, like a split second radio broadcast
  • The xDrip app (on Android phone/tablet) controls the xdrip device to listen for and receive the Dexcom data.
  • The app displays information about the person’s glucose levels now and over the last day or so, indicating whether it rising or falling or staying level
  • If required the app can upload the data to a Nightscout database. We didn’t do this initially but set it up within the first week.
  • If using Nightscout parents (etc.) can view Nightscout info on a PC/website/smartwatch, like on the right. I’ve seen some great pictures of parents looking at their kid’s glucose level being displayed on the parent’s Pebble watch whilst the kid does some activity with their friends.
  • A further step is the use of another Android/smartphone application named Nightwatch, also written by Stephen. It relays information from the Nightscout data onto a secondary phone and potentially on to a smartwatch.

That’s Stephen’s SmartWatch above/right, showing the glucose levels on mg/dl (so don’t panic UK people).

Stuff you’ll need before using xDrip

  • Dexcom G4 CGM system, including transmitter and sensors.
  • An Android phone or tablet running version 4.3 or above and the ability to use BLE.
  • Components for the xDrip device (Wixel (£14), LiPo battery (£6) and charger (£6), BLE module (£15) and some wires to link it all together.
  • A case to put all the components in. (Yes I really must buy a case soon.)
  • A soldering iron or a friend/relative with one. I bought one off eBay for £12 including the iron, solder, iron stand/sponge and magic hands with magnifying glass.
  • A bit of patience. I didn’t have any but on reflection it would probably be a good thing.

In this next blog I detail the components I bought, which are pretty much the same components Stephen Black (the creator of xDrip) used.

Is this really a do-it-yourself project?
Yes. Definitely.
Before starting on this project I had never soldered any electrical components, I even had to buy a soldering kit specifically for this. Fair enough I program computers for a living but in this case my knowledge actually hindered my progress as I looked for a complicated solution to a problem I didn’t actually have. Luckily Stephen was on hand (via Twitter) to help me through it.
Soldering wise I’d say I spent a couple of hours in elapsed time making up the device, but that’s only because I was taking it very slowly to make sure I got nothing wrong. I’d imagine anyone with soldering experience would have this done in a few minutes.
If you don’t feel you can solder the components together why not ask a friend, relative or colleague?

xDrip's first 'catch'A real life example
With the xDrip device in Amy’s room, we checked that our tablet’s xDrip app could communicate with it when in our bedroom and also when downstairs in the kitchen; it could.
Off to bed we all went, everyone drifting off quick quickly, except me as I was busy staring at a tablet mesmerised by the information in front of me. (I really hope that’s a first night thing!)
At 7am I woke up and went downstairs, taking the tablet with me but not looking at it, placing it on charge in the kitchen, underneath Amy’s bedroom. I heard a noise and presumed it to be a mobile getting a Facebook notification or something. Then it happened again.
I realised it was Amy’s Animas Vibe pump vibrating to tell her that something wasn’t great, it was right she was low. Amy was fast asleep with the pump lying on the mattress beside her, she couldn’t feel it, it didn’t wake her. On the other hand I was in the room underneath and heard it, the vibration going through the mattress, down the bed itself, onto the floorboards, through the joists and onto the ceiling below!
So I checked the tablet and saw the image on the right. I waited 10 minutes to see if her level improved – it didn’t – and went up to wake her to give her a few glucose tablets. Amy went straight back to sleep, I went downstairs happy that she was no longer in danger.
Twenty minutes later I was pleased by the 5.5mmol showing on the xDrip app.

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Interested in what components you’ll need to build xDrip? Then read this: #WeAreNotWaiting thanks to #xDrip – Components Required