FAQ

All Canadian residents on multiple daily injections of insulin, or on an insulin pump, are invited to join BC Diabetes for looping services. Services are provided under MSP (excluding Quebec residents). If you already have an endocrinologist or diabetes doctor, your primary care will remain with them. BC Diabetes will provide ongoing secondary support including installation and configuration of your looping software. Please visit our website to register. 

We are not accepting patients outside of Canada at this time.

Solution 1: Restart your phone then wait for your next CGM reading (<5 min) 

Solution 2: If you recently replaced your Dexcom transmitter, please enter your new transmitter ID into Loop by following the instructions below. If you have done so already, please confirm you have entered the correct ID.

1. 1. Open the Loop App: Launch the Loop app on your device.

   2. Access Settings: In the Loop app, tap on the "Settings" option located in the bottom right corner.

   3. Choose Dexcom G6: Scroll down to locate the "Dexcom G6" option and tap on it.

   4. Delete CGM: Once in the Dexcom G6 settings section, scroll down to the bottom and tap on "Delete CGM." This step will clear the old transmitter information from the app.

   5. Add CGM: After deleting the CGM, navigate back to the same "Dexcom G6" settings section. You will now see an option labelled "Add CGM" which has replaced the "Dexcom CGM" entry. Tap on "Add CGM."

   6. Follow Setup Steps: Follow the steps to add your new CGM using the updated transmitter ID. Make sure to input the correct information to ensure accurate readings.

   7. Skip Dexcom Share Credentials: During the setup process, you will come across a section asking for "Dexcom Share Credentials." You can skip this step – it's not necessary for your Loop setup.

   8. Activate Upload Readings: Once you have successfully added your new CGM using the updated transmitter ID, locate the new "Dexcom G6" entry in the settings. Tap on it to access its settings. Inside find the option to "Upload Readings" and turn it on. This step ensures that your Loop app sends accurate and up-to-date data to your nightscout account.

For additional support, contact us at 604-683-3734 during office hours, or reach out to members of our online support group.

Errors with Loop crashing in the background are elusive and tend to be associated with older iPhone models. Here are two things you can try:

1. Turn off low battery mode on your phone.

2. Leave the Dexcom and Loop app open in the app switcher.

Please open up TestFlight on your iPhone and make sure your Loop app is fully updated. If Loop is missing from your list of apps in TestFlight, contact BC Diabetes during office hours or via Slack to re-add you back to the beta program.

When you are sick, your sugars often run higher than average. This places you at an increased risk of diabetic ketoacidosis (DKA), a life threatening condition. Any blood ketone value >0.6 is abnormal and requires immediate action.

1. Test your sugar every 15 minutes - your target is < 10.0 

2. Test your ketones every 2 hours - your target ultimately is < 0.6 though this may take 12-18 hours; the main thing is that your ketone level is dropping steadily

3. Push salty fluids: drink 1-2 cups of beef, chicken or vegetable broth every 30 minutes (or make up your own normal saline solution by dissolving 1 level teaspoon of salt in 2 cups of water or 2 level teaspoons in a litre of water).

4. Take extra rapid insulin every hour until your sugar is < 12. *In Loop, you can set a custom preset for sickness, starting with 115% greater insulin delivery, and increasing as needed. See below for more information

5. Go to hospital if you are unable to keep fluids down, or after 8 hrs if your sugar is still > 15

*Occasionally the built-in settings of Loop, iAPS and AAPS are insufficient to deal with the markedly increased insulin resistance associated with illness and medication like prednisone and other glucocorticoids such as dexamethasone and cortisone. If you see your sugars soaring and you’ve checked for pump failure etc, BCDiabetes suggests you make the following changes to your settings.

Step 1: Amplify insulin delivery across the board:

In Loop push Custom Preset to the maximum of 200%

In iAPS select your profile, and increase insulin to 200%

In AAPS activate your profile, and increase insulin to 200%

And wait a couple of hours

Step 2: Go into your primary settings for ICF, ISF and basal rates and double the insulin delivery for each setting:

For ICF halve the number: if your current setting is 10, reduce it to 5

For ISF halve the number: if your current setting is 2, reduce it to 1.0

For basal rate double the number: if your current basal rate is 1.0U/hr make it 2.0U /hr.

And wait a couple of hours

Step 3: Go back into your primary settings for ICF, ISF and basal rates and re-double the insulin delivery for each:

For ICF halve the number again: if your current setting is 5, reduce it to 2.5

For ISF halve the number again: if your current setting is 1.0, reduce it to 0.5

For basal rate re-double the number: if your current basal rate is 2.0U/hr make it 4.0U /hr.

The moment your numbers start to bottom-out return amplification (Step 1) to your usual setting, typically 100% (in this example reduce from 200% to 100%), and go into your primary settings and gradually reverse the changes you made in Steps 1 and 2 to reduce insulin delivery for ICF, ISF and basal rates.

More Information

Loop systems have shown to be reliable. Nonetheless, things can go wrong so it is important you prepare for the worst. BC Diabetes recommends the following backup supplies, especially when planning to travel long distances.

• Rapid insulin pen and pentips 

• Finger poker, strips & device for blood glucose testing 

• Sugar/carb source (or glucagon) 

• Basal insulin pen and pentips

More Information

Please also note that if you are travelling to a different time zone, you may need to update your pump's time. To synchronize the time on the pump, tap:

1. Settings

2. Omnipod

3. Change Time Zone. This loads your basal schedule onto the pod based on the current time on the Loop phone. Make sure phone, radio-link and pod remain in close contact until this step completes

See LoopandLearn's documentation for more information.