Trio Explained: Dynamic Automated Insulin Delivery

[@zachazlett]

I’ve been using Trio since the release of .2 last month. I’ve actually given a normal bolus 2 or 3 times. Every other meal I just give it a very rough carb, fat, and protein count then Trio takes care of the rest. I’m hitting 97% to 100% in range with an aggressive BG of 120.

[@zachazlett]

@@darrelld3605 no

[@craigclark5845]

Been running this since the dev release, my TIR is up 30% plus. I love the live activity too so I can see my sugar without opening my phone. Thanks Theresa, thanks Magnus. Great episode Justin

[@diabe_tech]

Thanks for the details! Glad you enjoyed.

[@grostecki]

I use Loop for my 5 year old son. In Loop it is important to enter carbohydrates correctly. We usually have a problem with correctly estimating the amount of carbohydrates, which is why he is often high. In Trio the UAM function works great. It prevents highs due to inaccurate entries, stress, or snacking. If Trio has TrioCaregiver 🙂for remote commands we will definitely switch from Loop.

[@zachazlett]

@@darrelld3605 no

[@defiantt1d]

A version of Loop Caregiver for Trio is in the works. It won't be a carbon copy of Loop Caregiver, but we hope to add some of the same functions that Loop caregivers find useful!

[@brendaparker6766]

We have a 7 Y/O granddaughter T1D since 5…Needs FDA approval for school nurse to participate in regulating needs at school. Hoping this will happen soon!

[@MikePlante1]

@@brendaparker6766 Trio is not even seeking FDA approval at this time, but I’d encourage you to look into Sequel Twiist, which is FDA cleared and will use the Tidepool Loop algorithm/app which is based on the DIY Loop app/algorithm.

[@MatthewCrane-vm4fm]

@@defiantt1d Can't wait, people often only think about the adults, but forget the struggling parents trying to control children while not immediately near them (school, friend/relatives house, date night, etc). We really, really need something soon. Thank you!

[@SteenLarsen]

Sounds like a great app for Apple users. The development level cleanup is impressive and the new look is awesome!

[@MPYES2483]

Trio has been great . Went from 67% TIR to 88%. Average glucose went from 155 to 132

[@zachazlett]

@@darrelld3605 no

[@MPYES2483]

@@darrelld3605 I’ve used omnipod 5 for over a year and can say trio is way better for me. That 67% TIR was with omnipod 5. I think pump manufacturers should stick with just making good pumps. The whole algorithm thing should be separate and allow the person to choose what works best.

[@brendanhyland2718]

Guys, why can’t I see the Trio app in the Apple App Store?!?! I’m in the UK.

[@soozzi]

Five years looping. It was a game-changer. Now I’m curious whether Trio can do better.

[@SwissPGO]

quick question: can data be shared between loops and trio, so that when moving from one app to another that much of the data is retained ? And... can I have multiple phones too that share the data (off course only one can be the active device). I have multiple iphones (part of my IT job) and I could see those as emergency backup devices in case my main phone goes titsup.

[@revpops]

Does it work with Medtronic mini med 780G pump with guardian 4

[@defiantt1d]

No. The 780 has it’s own algorithm and does not work with any other system.

[@inspectorgadget346]

Been on AAPS for about a year and just moved to IAPS as I got a new iPhone. I’m a bit skeptical of going to Trio right now. I understand it’s a Fork from IaPS, I just want to see where it goes before making the switch. Justin how’s it working for you vs IAPS?

[@estebansolano3855]

Is there any open source DIY hardware project?

[@MrAlhaines]

where do I get one

[@rosesingleton5517]

Justin, if you are not using Trio now what are you using?

[@rosesingleton5517]

@@darrelld3605 plus he has not an me

[@defiantt1d]

He has been trialing various commercial systems. I believe he posted about it recently.

[@diabe_tech]

I’m currently using Omnipod 5 + the iPhone app and using Dexcom g6. Next up, Mobi, then I want to try out Medtronic 780g. I also may go back to InPen for a little bit. Will probably come back to Trio after all of that so I can truly compare it all!

[@conradoventura4628]

Guys, hello. New to Justin's channel, and amazed about some great info learning here that I was never informed of from Endocrinos (frustrating) I just learned about iAPS or even Loop in general. I really wanted to try using this tool. Anyone could suggest where to go to start from scratch in getting it built? Theresa mentioned a couple places, but I needed something really from scratch. Any suggestions? Thanks for the help!!!

[@diabe_tech]

Go to trio docs dot org and read everything you need there. Loop docs dot org to learn about Loop :)

[@theemurman1]

This is great! All I need is a computer engineering degree.

[@facundorodriguez5442]

Donde puedo conseguir ayuda para esta apps mi nena usa la bomba medtrum nano

[@celialevesque3166]

Please more podcasts on Trios. I am interested in how the updates are going in the APP

[@zachazlett]

@@darrelld3605 no

[@diabe_tech]

I’ve got another one coming!

[@zachazlett]

@@diabe_tech great!

[@ForceFreeTrainergirl06]

And of course someone's going to ask....... is there going to be an android version soon please?

[@andreasstokholm2505]

Android has it's own application with the same algorithm. It's called AAPS, or Android APS.

[@dnzxy]

There is AndroidAPS for Android, which has been around for a long time, and uses the same algorithm. Check it out.

[@yanina7977]

Also big thanks to Marvin :)

[@defiantt1d]

HUGE thanks to Marvin!!!!

[@Jilvanirandoust]

How do you start using this system??

[@zachazlett]

@@darrelld3605 no

[@karenmielish-clausell]

Can you use trio on certain pumps or all pumps

[@defiantt1d]

Only on pumps that have been reverse engineered. Currently, Trio is compatible with Omnipod Dash, Omnipod Eros (discont), and older Medtronic pumps. Soon Dana and Medtrum will be added to the list, but not quite yet.

[@kingofkingz235]

How about tandem t slim x2?​@@defiantt1d

[@defiantt1d]

@@kingofkingz235there is some work on reverse engineering the mobi, but no promises yet

[@zachazlett]

@@darrelld3605 no

[@EdwardBaker-be7cq]

Is trio compatible with the Omnipod dash?

[@diabe_tech]

Yes

[@brendaparker6766]

So hopeful, need to get FDA approval so insurances will cover!

[@diabe_tech]

into that!

[@inspectorgadget346]

These will never be fda approved because people have created the code to work for them. However there is a closed loop coming called Twiist that will be FDA approved that is closed loop however doesn’t use the OREF1. I use omnipod dash with iaps/trio. The companies that make their own product like in use withOmnipod 5 or a pump like tandem x2 have built in algorithms that are proprietary

[@dahnerodriguez]

Do you need to useiAPS or is Trio just another app option that you need to build? Sounds good and I would like to try it. Thanks for this video, Justin.

[@defiantt1d]

Trio is separate from iAPS. If you’ve used Loop, the build is the same for Trio. One of the Loop developers ensured the same build options from Loop are also available for Trio.

[@dahnerodriguez]

@@defiantt1d thank you

[@dahnerodriguez]

I don’t eat carbs, I eat carnivore. Do I still need to enter a carb amount at mealtimes or can I just enter the fat and protein for possible bolus? I currently add “fake carbs” on Loop.

[@defiantt1d]

With UAM (Unannounced Meals) combined with Autosens or dynamicISF, you shouldn't need to enter fake carbs. You can enter carbs, fat, and/or protein for meals and it will convert the fat and protein into future carbs equivalents so the algorithm utilizes your carb ratio at future times. What some are able to do is only enter the macros and let the algorithm handle the rest through micro boluses (SMBs). Others, like Magnus, only enter an estimated bolus and let UAM handle the rest. Then, some like myself, do not enter anything and let the combination of UAM and dynamicISF take care of it all. What works for you is individual, but there are multiple ways to handle meals with Trio.

[@dahnerodriguez]

@@defiantt1d this sounds great! It’s been trying not eating carbs but still having to enter them to keep a stable bg. But as far as building, I follow tge Loop Docs but use Trio codes. Is that correct?

[@zarasbubble1748]

You don’t need to enter carbs. Just enter protein and fat.

[@dahnerodriguez]

@@zarasbubble1748 thanks

[@ghostboy4091]

Is there a way to get the 1.0.0 release?

[@andreasstokholm2505]

Not yet. Patience is the name of the game here :)

[@zachazlett]

@@darrelld3605 no

[@JonasHummelstrand]

@@darrelld3605 You have been very vocal in your support of iAPS. Are you now saying that all DIY solutions should be abandoned?

[@ghostboy4091]

@@andreasstokholm2505 Thank you for the response!! Been loving Trio and looking forward to the 1.0.0 release!

[@lthomas63]

Looks very promising!

[@zachazlett]

@@darrelld3605 no

[@bethanyirene7120]

Does this work with the OmniPod?

[@MikePlante1]

Yes for Omnipod Dash and Eros/Classic/Gen3... NO for Omnipod 5 pods.

[@e.m.b1057]

Hello is trio compatible with medtrum insuline pump

[@diabe_tech]

Not that I know of.

[@Gergoool]

You mean Medtronic 780G?

[@e.m.b1057]

@@Gergoool No I mean medtrum, they have a pump called "Touchcare nano", it is a tiny pump which can hold 300UI.

[@dnzxy]

There is work being done to port the Android Medtrum Nano drivers used in AndroidAPS to iOS (so Trio, but theoretically also Loop), but that will definitely be a lot of work until it's there. Not in the near future.

[@zachazlett]

@@darrelld3605 no

[@RajeshPatel-sy5xu]

Any TYPE one diabetes group in USA

[@carolvachon48]

There are lots of t1d groups in the US. Search for one that meets your interests. Ask questions Use that information to join a few new groups

[@Barry-v6s]

Will this work on a T Slim X2?

[@afeher]

No

[@Barry-v6s]

@@afeher thank you. What pump will Trio work on?

[@defiantt1d]

@@Barry-v6sCurrently, Omnipod Dash, Omnipod Eros, certain older Medtronic pumps, and very soon Dana pumps.

[@zarasbubble1748]

I honestly cannot believe some of the comments you’re getting on here. PLEASE keep promoting all advancements, DIY or not. ❤

[@diabe_tech]

I’m just here to educate 🤓

[@diabetesatuniversity]

It really sounds amazing. DIY solutions for diabetes care seem so much better. At the same time, I would like to know more how what sort of diet Theresa follows. Theresa, do you eat a "normal" diet, or do you evade foods with a high glycemic index in order to have the fully automatic mode to work?

[@defiantt1d]

I eat a normal diet. Not anything close to low carb. I enjoy sweets and pastries.

[@ForceFreeTrainergirl06]

I started using AAPS 30 days ago using the Omnipod and the G7. I am on average 80 to 90 % in range. I don't bolus very often. I eat a normal diet, and I don't worry about glycemic indexes or low carb. Life's too short for that, especially if you've have T1 for 55yrs like me. I eat sweet stuff, like cakes sometimes. I maybe eat a couple of slices of bread a day, and as I am a veggie I do eat quite a lot of carbs, being pasta, rice etc. But I don't really eat a huge amount and I have never used much insulin anyway. I normally use about 14 to 17 units in a day, basal/bolus included and it's been that way for most of my life with T1.I know for some people it changes but not for me. Before I started on AAPS closed loop, I was between 50% and 70% in range. Like Theresa said in the video, I don't worry too much about whether I am 90% or more in range. I'm quite happy being in the 80% figure somewhere.

[@diabetesatuniversity]

​@ForceFreeTrainergirl06 It is interesting that some people use relatively low doses although that is of course depending on body weight as well. Of the top of my head the average type 1 insulin use is around 0.6 U per kilo body weight. Glad to hear AAPS system works so well too.

[@zachazlett]

@@darrelld3605 no

[@diabetesatuniversity]

@@darrelld3605 Fewer than 50% of people using Omnipod5 manage to have a time in range over 70%, here is a short summary of their own data on that: kzbin.info/www/bejne/iHPVqqeam7WonJI

[@JSW42]

Will this ever be on Android phones and watches? I'll expire before I ever use an Apple product again.

[@diabe_tech]

There is Android APS which uses the same algorithm!

[@LarryMartin1956]

If the app is not FDA approved, how do you get around Medicare requirements that they will only pay for insulin using approved devices? Do you have to pay for your insulin out of pocket?

[@bbllaakkee]

you use an approved device that works with the app...

[@dahnerodriguez]

My insurance pays for my Omnipod Dash pods, insulin and cgm. I don’t use the PDM. I just use Loop or in this case you can use Trio to administer insulin through these apps.

[@defiantt1d]

@@Vivd90your phone replaces the pdm. It is not used at all.

[@dahnerodriguez]

@@Vivd90 I built the Loop app. Then when it was time to change my pod, I setup the new pod on Loop. I don’t use the PDM any more. I keep it handy though incase I need to replace a pod since many have said that Insulet asks for the PDM serial number. I get more accurate dosing with the Loop app and my iPhone replaces the PDM

[@BOLUSLife]

Imagine "them" taking away insulin because you downloaded an app

[@mikemcd879]

dam I am not an apple person, i am using android AAPS. all the apple apps are nice and sleek. android always gets the short end ...sorry never use apple again

[@orgadsalomon5160]

Is Trio 1.0? it'a 0.2.1 isn't it?

[@LarryMartin1956]

Btw lock screen and all of this I have in Android with my 780g and xdrip. Totally customizable with what is on the widget and lock screen. Even color and placement of the lock screen text.

[@kingofkingz235]

This sucks is an apple app 😒👎

[@evan.whobrey]

AAPS is basically the same app for android, it's the oref algo for android devices.

[@defiantt1d]

AndroidAPS can be found in the same GitHub repository. Same base algorithm. If you are looking for an Android option, definitely start there!

[@dsut4393]

It's just a tool, what's with the hate? If you want to use the same algorithm you can use AndroidAPS on and Android phone, or OpenAPS on a stand-alone rig, both of which have been around for longer than Trio.

[@talbenshahar]

Algorithm that let you go to 200-250 ???? Jesus..... this is bad.

[@defiantt1d]

85-90% TIR. Can get to 200-250 because I do not bolus for carbs and do not eat low carb.

[@talbenshahar]

Well, this is really not healthy

[@defiantt1d]

@@talbenshahar Which part is not healthy? I am between 70 and 180 mg/dL 85-90% of the time. My A1c over the last 3 years has been between 5.2 and 5.6. I am balancing my physical health and mental health needs and am very happy with my success. I have reasonable expectations of what this system can achieve as it uses imperfect tools. What other system can provide 85-90% Time in Range with such little mental work?

[@mad0uche]

You always advertise these third party systems like loop and now this that 99.9% of users wont ever use, I just don't get it I don't understand what your agenda is.

[@defiantt1d]

These aren’t 3rd party. They’re made by people with diabetes, free, and what is pushing the diabetes industry forward.

[@mad0uche]

@@defiantt1d yeah like I said, 3rd party

[@evan.whobrey]

If you want the best control, you would be wise to consider Trio or Loop. In fact commercial systems are now incorporating automation based on the very foundations laid by Loop and Trio.

[@zachazlett]

@@darrelld3605 no

[@JonasHummelstrand]

@@darrelld3605 Are you using the Omnipod 5, Darrell?

[@LarryMartin1956]

I will NEVER use ANYTHING Apple. Fix this for the majority of smartphone users in the world like me!

[@MPYES2483]

Use AAPS that’s the android version

[@johndoe-kh9fu]

Already done my guy

[@dsut4393]

It's just a tool, what's with the hate? If you want to use the same algorithm you can use AndroidAPS on and Android phone, or OpenAPS on a stand-alone rig, both of which have been around for much longer than Trio. This particular tool is made by people with diabetes who happen to like iOS, they're volunteers who don't owe you anything. If you think the app looks good, consider that it was made with Apple tools, using standard iOS user interface elements, and following Apple design guidelines, so perhaps you secretly have a thing for Apple after all? 😜

[@LarryMartin1956]

I just don't get it! You are open source but you are on a totally closed source operating system. This should have been developed for Android first. Sorry I just do not get this and you may need to block me but this is backwards.

[@zachazlett]

We get it. This app isn’t for you.

[@johndoe-kh9fu]

It was developed on android first under AAPS

[@andreasstokholm2505]

The same algorithm is available on Android under the name AAPS.

[@zachazlett]

@@darrelld3605 no

[@zachazlett]

@@darrelld3605 no