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people are hacking their insulin pumps

known to some as “looping," it’s a system in which a continuous glucose monitor (cgm) can “talk” to a pump through a smartphone app

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around the world, thousands of people with type 1 diabetes are finding ways to hack into their insulin pumps by carefully following instructions they find online.
the process involves making small, computerized adjustments that make the device smarter by giving it the capability to adjust itself, acting as an artificial pancreas. it’s a diy revolution that allows the pump to automatically determine how much insulin to give a user throughout the day.

the atlantic describes type 1 diabetes as a disease where the pancreas is unable to produce insulin to control blood sugar. a healthy pancreas automatically does the appropriate calculations to regulate insulin in the body.

but people with type 1 diabetes have to meticulously count out every gram of carbohydrates in each meal before telling their pump how much insulin to give. if there’s even a small miscalculation, there can be severe consequences. extremely high or low blood sugar can be deadly.
known to some as “looping,” it’s a system in which a continuous glucose monitor (cgm) can “talk” to a pump through a smartphone app. the two wearable devices are currently not connected, so users have to manually and constantly readjust their insulin doses according to the monitor.
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in 2014, hackers realized that they could override old wearable insulin pumps (the newer ones aren’t hackable) with their own algorithm that lets the cgm tell the pump how much insulin the person needs, with the pump automatically administering the appropriate dose.

it uses a device called a rileylink that converts the signals from the cgm into readable information for the smartphone. hackers shared the code, called openaps online, and it’s been catching on ever since.

dana lewis, a pioneer in the field of diy insulin pumps and one of the creators of the openaps, told medical press , “i wanted to share my solution with other people. from the beginning, it was a patient-driven movement of people who said, ‘i want to have choices.'”

“this was all about how do we fill the gap until there’s something commercially available,” she said. while these are concerns, for many diabetics the risk factors may be outweighed by the cost benefits that looping offers them.
for years, doctors have worked towards creating artificial pancreas that can do the same as the new automated insulin pumps hitting the market. while aimed at making regulating diabetes more manageable, the cost of these new pumps can be a drawback. medical press reports that in 2018, the fda cleared a medtronic system that includes automated insulin delivery in the us — with a price tag of about $7000 before insurance.

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experts told medical press that the practice feeds “an underground used-insulin pump market” where users are buying pumps with known security vulnerabilities. and with those security vulnerabilities, comes some dangers.
the fda has already issued warnings advising diabetics to avoid building their own insulin systems after one person accidentally overdosed on insulin. in a statement to medical press, the organization said they are “concerned about people with diabetes using unauthorized devices for diabetes management used alone or along with authorized devices.”

certain models of some insulin pumps have been recalled due to potential cyber security risks related to the pumps’ wireless communications. medical economics writes how hackers could potentially hack into users’ pumps’ wirelessly and change the settings. this could cause insulin to be over-delivered to a patient which could lead to low blood sugar, high blood sugar, stopped delivery and diabetic ketoacidosis.

for more information on diabetes, support or to connect with other patients, visit diabetes canada.

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