Doelen

AAPS has a series of Objectives that need to be completed to walk you through the features and settings of safe looping. De leerdoelen zorgen ervoor dat je alles goed hebt ingesteld, en dat je snapt wat het systeem doet en waarom. Zodat je erop kunt vertrouwen dat het de juiste keuzes maakt.

If you are upgrading phones then you can export your settings to keep your progress through the objectives. Not only will your progress through the objectives be saved, but also your safety settings such as max bolus etc. If you do not export and import your settings then you will need to start the objectives from the beginning again. It is a good idea to backup your settings frequently just in case.

If you want to go back in objectives see explanation below.

Doel 1: Instellen van visualisatie en monitoring en analyseren van basaal en ratio’s

  • 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 AAPS driver for looping) to ensure your pump status can communicate with AAPS.

  • If using DanaR pump then ensure you have followed DanaR Insulin Pump instructions to ensure the link between pump and AAPS.

  • You need to establish a data repository/reporting platform to complete this objective. That can be accomplished with either Nightscout or Tidepool (or both). Follow instructions at the Nightscout or Tidepool page for instructions.

  • 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 AAPS will recognise it.

Objective 2: Learn how to control AAPS

  • Perform several actions in AAPS 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 doel 2

Doel 3: Bewijs jouw kennis

Objective 3 is a multiple choice test based on questions designed to test your theoretical knowledge of AAPS.

Some users find Objective 3 to be the most difficult objective to complete. Please do read the AAPS documents in conjunction with the questions. If you are genuinely stuck after researching the AAPS documents, please search or ask for help on the Facebook or Discord group. These groups can provide friendly hints or redirect you to the relevant part of the AAPS documents.

To proceed with Objective 3, click on the orange text “Not completed yet” to access the relevant question. Please read each question and select your answer(s).

Within each question, a hyperlink to the AAPS documents will guide you to the relevant section of the document which you should read in order to locate the correct answer.

Obj3_Screenshot 2023-12-05 223422image

For each question, there may be more than one answer that is correct! If an incorrect answer is selected, the question will be time locked for a certain amount of time (60 minutes) before you can go back and answer the question.

After updating to a new version of AAPS, new questions may be added to cover a prevalent issue picked up by AAPS or alternatively to test your knowledge of a new feature of AAPS as released.

When AAPS is installed for the first time, you will have to complete Objective 3 entirely in order to move onto Objective 4. Each objective is required to be completed in sequential order. New features will gradually be unlocked as progress is made through the objectives.

What happens if new questions are added later to Objective 3? From time to time, new features are added to AAPS which may require a new question to be added to Objective 3. As a result, any new question added to Objective 3 will be marked as “incomplete” because AAPS will require you to action this. As each Objective is independent, you will not lose the existing functionality of AAPS providing the other objectives remain completed.

Doel 4: Beginnen met een 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 AAPS that you have accepted them. Ensure this data shows in AAPS and Nightscout.

  • Enable temp targets if necessary. Gebruik bijvoorbeeld een tijdelijk hypo streefdoel om te voorkomen dat het systeem te sterk corrigeert voor een stijgende bloedsuiker na een hypo.

Verminder het aantal meldingen

  • To reduce the Number of decisions to be made while in Open Loop set wide target range like 90 - 150 mg/dl or 5,0 - 8,5 mmol/l.

  • You might even want to wider upper limit (or disable Open Loop) at night.

  • In Preferences you can set a minimum percentage for suggestion of basal rate change.

    Open Loop Minimale verzoek voor aanpassing
  • Also, you do not need to act every 5 minutes on all suggestions…

Doel 5: De Open Loop begrijpen, inclusief de voorgestelde tijdelijke basaalstanden

Je wilt beginnen met een streefdoel dat hoger is dan normaal, totdat je vertrouwen in de berekeningen en de instellingen hebt gekregen. Het systeem staat toe

  • 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)

Het streefdoel is de waarde waar de berekeningen op zijn gebaseerd, en is niet hetzelfde als waar je jouw bloedglucose waarden binnen wilt houden. If your target is very wide (say, 3 or more mmol [50 mg/dl or more] wide), you will often find little AAPS action. Dit komt omdat de voorspelde bloedglucose meestal binnen dat brede bereik zal liggen en het systeem dus niet vaak een andere tijdelijk basaal voorstelt.

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-teken

Stop hier als je een virtuele pomp gebruikt en in Open Loop wilt blijven - klik NIET op Verificatie aan het einde van dit doel.

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Doel 6: Starten in Closed Loop met bescherming tegen lage BG

Waarschuwings-teken

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!

  • Prerequisite: You need a good profile (basal, ISF, IC) already working in AAPS to start with Loop in Low Glucose Suspend mode. Otherwise you can run in a hypo which you have to manually correct. This will help you a lot 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 and do NOT start objective 6 at this time.

  • You don’t have to change your settings now. During objective 6, the maxIOB setting is internally set to zero automatically. This override will be reversed when moving to objective 7.

  • The system will override your maxIOB settings to zero, which means if blood glucose is dropping it can reduce basal for you. If blood glucose is rising then it will only increase basal if the basal IOB is negative from a previous Low Glucose Suspend. Otherwise basal rates will remain the same as your selected profile. That means that you have to manually handle high values with insulin corrections.

  • If your basal IOB is negative (see screenshot below) a TBR > 100% can be issued also in objective 6.

Voorbeeld negatieve IOB
  • Set your target range slightly higher than you usually aim for, just to be safe and have a bit more scurity buffer.

  • Enable ‘Low Glucose Suspend’ mode either by by pressing and holding the Loop icon at the top right corner of the home screen and selecting the Loop - LGS mode icon.

  • Watch how temporary basals are active by viewing the blue basal text on the homescreen or the blue basal render on the homescreen graph.

  • You may temporarily experience spikes following treated hypos without the ability to increase basal on the rebound.

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

  • Select ‘Closed Loop’ either from Preferences or by pressing and holding the Loop icon at the top right corner of the home screen, over a period of 1 day.

  • Raise your ‘Maximum total IOB OpenAPS can’t go over’ (in OpenAPS called ‘max-iob’) above 0. The default recommendation is “average mealbolus + 3x max daily basal” (for the SMB algorithm) or “3x max daily basal” (for the 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).

    Deze aanbeveling moet als uitgangspunt worden beschouwd. If you set to the 3x and you are seeing moves that push you too hard and fast then lower that number. If you are very resistant, raise it very little at a time.

    max dagelijkse basaal
  • Once confident on how much IOB suits your looping patterns, then reduce your targets to your desired level.

Doel 8: Pas basaalstanden en de ratio’s aan indien nodig, activeer hierna de Autosens optie

  • 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 AAPS is adjusting the basals and/or targets accordingly.

Don’t forget to record your looping in this form logging AAPS as your type of DIY loop software, if you have not already done so.

Objective 9: 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 bevat nu alle IOB, niet alleen de toegediende basale insuline. 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. Je moet dit handmatig doen wanneer je van AMA naar SMB wisselt.

Objective 10: Automation

  • You have to start objective 10 to be able to use Automation.

  • Make sure you have completed all objectives including exam Objectives-objective-3-prove-your-knowledge.

  • Completing previous objectives will not effect other objectives you have already finished. Je behoudt alle reeds afgeronde doelen!

Objective 11: Additional Features such as DynamicISF

  • You have to start objective 11 to be able to use DynamicISF

Teruggaan in doelen

Als je om welke reden dan ook terug wilt gaan in de leerdoelen druk dan op “voltooiing wissen”.

Teruggaan in doelen

Objectives in Android APS before version 3.0

One objective was removed when Android APS 3.0 was released. Users of Android APS version 2.8.2.1 who are on older Android software (i.e. earlier than version 9) will be using an older set of objectives which can be found here.