2018年糖尿病技術極有前途的狀態
This blog post is an update to these two Diabetes Technology blog posts:
這篇部落格文章是對這兩個糖尿病技術部落格文章的更新：
You might also enjoy this video of the talk I gave at WebStock 2018 on Solving Diabetes with an Open Source Artificial Pancreas
您可能還會喜歡我在WebStock 2018上發表的關於使用開源人工胰腺解決糖尿病的演講視訊*。
First, let me tell you that insulin is too expensive in the US.
首先，讓我告訴您，在美國，胰島素過於昂貴。
Between 2002 and 2013, the price of insulin jumped, with the typical cost for patients increasing from about $40 a vial to $130.
在2002年至2013年之間，胰島素的價格猛增，患者的典型費用從每瓶約40美元增加到130美元。
For some of the newer insulins like the ones I use, I pay as much as $296 a bottle. I have a Health Savings Plan so this is often out of pocket until I hit the limit for the year.
對於一些較新的胰島素，例如我使用的胰島素，我每瓶要支付296美元。 我有一個“健康儲蓄計劃”，因此在我達到全年限額之前，這通常是不花錢的。
People in America are rationing insulin. This is
在美國，人們正在配給胰島素。 這是可證明的事實。 我個人已將多餘的胰島素郵寄給有需要的人。 我遇到了一些年輕人，他們在26歲時失去了保險，不得不跳過鏡頭以儲存一小瓶胰島素。
This is a problem, but on the technology side there's some extremely promising work happening, and it's we have really hit our stride in the last ten years.
這是一個問題，但是在技術方面，正在發生一些非常有前途的工作，這是我們在過去十年中取得了長足的進步。
I wrote the first Glucose Management system for the PalmPilot in 1998 called GlucoPilot and provided on the go in-depth analysis for the first time. The first thing that struck me was that the PalmPilot and the Blood Sugar Meter were the same size. Why did I need two devices with batteries, screens, buttons and a CPU? Why so many devices?
我在1998年為PalmPilot編寫了第一個葡萄糖管理系統，稱為GlucoPilot，並首次提供了進行中的深入分析。 讓我震驚的第一件事是PalmPilot和血糖儀的尺寸相同。 為什麼我需要兩個帶有電池，螢幕，按鈕和CPU的裝置？ 為什麼有那麼多裝置？
I've been told every year the a Diabetes Breakthrough is coming "in five years." It's been 25 years.
每年我都被告知糖尿病突破將在“五年內”到來。 已經25年了。
In 2001 I went on a trip across the country with my wife, an insulin pump and 8 PDAs (personal digital assistants, the "iPhones" of the time) and tried to manage my diabetes using all the latest wireless technology...this was the latest stuff 17 years ago. I had just moved from injections to an insulin pump. Even now in 2018 Insulin Pumps are expensive, mostly proprietary, and super expensive. In fact, many folks use insulin pumps in the states use out of warranty pumps purchased on Craigslist.
2001年，我與妻子，胰島素泵和8臺PDA (當時的個人數字助理，當時的“ iPhone”)一起出國旅行，並嘗試使用所有最新的無線技術來管理糖尿病。 17年前的最新資料。 我剛剛從注射轉向胰島素泵。 即使在現在的2018年，胰島素泵也很昂貴，大多是專有產品，而且非常昂貴。 實際上，許多人在州使用在Craigslist上購買的不在保修範圍內的胰島素泵。
Fast forward to 2018 and I've been using an Open Source Artificial Pancreas for two years.
快進到2018年，我已經使用開源人工胰腺兩年了。
OpenAPS - Open Artificial Pancreas System. A platform for building a closed-loop with open tools.
OpenAPS-開放式人工胰腺系統。 一個使用開放工具構建閉環的平臺。
AndroidAPS - A branch of OpenAPS running on Android
AndroidAPS-在Android上執行的OpenAPS的一個分支
OpenAPS - Open Artificial Pancreas System. A platform for building a closed-loop with open tools.
OpenAPS-開放式人工胰腺系統。 一個使用開放工具構建閉環的平臺。
Loop/LoopKit - Open Source Artificial Pancreas running on the iPhone with a hardware bridge (RileyLink) to the pump.
Loop / LoopKit-在iPhone上執行的開源人工胰腺，具有到泵的硬體橋(RileyLink)。
I run this pancreas, personally, and have for nearly 2 years.
我親自操作這種胰腺，已經快兩年了。
Loop/LoopKit - Open Source Artificial Pancreas running on the iPhone with a hardware bridge (RileyLink) to the pump.
Loop / LoopKit-在iPhone上執行的開源人工胰腺，具有到泵的硬體橋(RileyLink)。
Watch Dana Lewis (the originator of OpenAPS) talk about OpenAPS at OSCON!
The results speak for themselves. While I do have bad sugars sometimes, and I do struggle, if you look at my blood work my HA1c (the long term measurement of "how I'm doing" shows non-diabetic levels. To be clear - I'm fully and completely Type 1 diabetic, I produce zero insulin of my own. I take between 40 and 50 Units of insulin every day, and have for the last 25 years...but I will likely die of old age.
結果不言自明。 雖然有時候我確實有不好的糖分，但我確實很掙扎，但是如果您看看我的血液功用，我的HA1c(“我做得如何”的長期測量顯示出非糖尿病水平。要明確-我完全完全是1型糖尿病患者，我自己產生的胰島素為零，我每天需要服用40至50單位的胰島素，並且在過去25年中一直服用...但是我很可能會死於老年。
Open Source Artificial Pancreas === Diabetes results pic.twitter.com/ZSsApTLRXq
— Scott Hanselman (@shanselman)開源人工胰腺===糖尿病結果pic.twitter.com/ZSsApTLRXq
-Scott Hanselman(@shanselman) September 10, 2018 2018年9月10日
This is significant. Why? Because historically diabetics die of diabetes. While we wait (or more accurately, #WeAreNotWaiting) for a biological/medical solution to Type 1 diabetes, the DIY (Do It Yourself) community is just doing it ourselves.
這很重要。 為什麼？ 因為歷史上糖尿病患者死於糖尿病。 當我們等待(或更準確地說， #WeAreNotWaiting )尋求針對1型糖尿病的生物/醫學解決方案時，DIY(自己動手)社群只是在自己動手做。
Building on open hardware, open software, and reverse-engineered protocols for proprietary hardware, the online diabetes community literally has their choice of open source pancreases in 2018! Who would have imagined it. You can choose your algorithms, your phone, your pump, your continuous glucose meter.
建立在開放硬體，開放軟體和專有硬體的逆向工程協議的基礎上，線上糖尿病社群實際上在2018年可以選擇開源胰腺！ 誰能想到的。 您可以選擇演算法，手機，泵，連續血糖儀。
Today, in 2018, you can literally change the code and recompile a personal branch of your own pancreas.
今天，在2018年，您可以從字面上更改程式碼並重新編譯您自己的胰腺的個人分支。
Watch my 2010 YouTube video "I am Diabetic" as I walk you through the medical hardware (pumps, needles, tubes, wires) in managing diabetes day to day. Then watch my 2018 talk on Solving Diabetes with an Open Source Artificial Pancreas*.
觀看我在管理糖尿病的日常醫療硬體(泵，針頭，管子，電線)中帶給我的2010年YouTube視訊“我是糖尿病”。 然後觀看我的2018年關於使用開源人工胰腺解決糖尿病的演講*。
I believe that every diabetic should be offered a pump, a continuous glucose meter, and trained on some kind of artificial pancreas. A cloud based reporting system has also been a joy. My wife and family can see my sugar in real time when I'm away. My wife has even called me overseas to wake me up when I was in a bad sugar situation.
我相信應該為每位糖尿病患者提供泵，連續血糖儀，並接受某種人造胰腺的培訓。 基於雲的報告系統也很令人高興。 我外出時，我的妻子和家人可以實時看到我的糖分。 我的糖狀況不好時，我的妻子甚至打電話給我，叫醒我。
As the closed-hardware and closed-software medical companies work towards their own artificial pancreases, the open source community feel those companies would better serve us by opening up their protocols, using standard Bluetooth ISO profiles and use security best practices.
隨著封閉式硬體和封閉式軟體醫療公司朝著自己的人造胰腺努力，開放原始碼社群認為那些公司可以通過使用標準藍芽ISO配置檔案和使用安全性最佳做法開放協議來更好地為我們服務。
Looking at the table above, the open source community is squarely in #4 and moving quickly into #5. But why did we have to do this ourselves? We got tired of waiting.
從上表可以看出，開放原始碼社群排在＃4之後，然後Swift進入＃5。 但是為什麼我們必須自己做呢？ 我們厭倦了等待。
All in all, through open software and hardware, I can tell you that my life is SO MUCH BETTER than it was when I was first diagnosed. I figure we'll have this all figured out in about five years, right? ;)
總而言之，通過開放的軟體和硬體，我可以告訴您，我的生活比第一次被診斷時要好得多。 我認為我們將在大約五年內解決所有問題，對嗎？ ;)
THANK YOU!
謝謝！
閱讀更多糖尿病 (MORE DIABETES READING)
Introducing Web Tiles for Microsoft Band - My diabetes data on a Band!
Diabetics: It's fun to say Bionic Pancreas but how about a reality check
It's WAY too early to call this Insulin Pump an Artificial Pancreas
* Yes there are some analogies, stretched metaphors, and oversimplifications in this talk. This talk is an introduction to the space to the normally-sugared. If you are a diabetes expert you might watch and say...eh...ya, I mean, it kind of works like that. Please take the talk in in the thoughtful spirit it was intended.
*是的，在本次演講中有一些類比，冗長的隱喻和過度簡化。 這次演講是對通常糖味的空間的介紹。 如果您是糖尿病專家，您可能會說...嗯...是的，我的意思是說，這種工作是這樣的。 請本著周到的精神進行演講。
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贊助商：早點回家，準時吃晚飯，並指導孩子們踢足球。 使用Azure NetApp檔案將工作負載轉移到Azure變得很容易。 註冊以預覽Azure NetApp檔案！
關於斯科特 (About Scott)
Scott Hanselman is a former professor, former Chief Architect in finance, now speaker, consultant, father, diabetic, and Microsoft employee. He is a failed stand-up comic, a cornrower, and a book author.
斯科特·漢塞爾曼(Scott Hanselman)是前教授，前金融首席架構師，現在是演講者，顧問，父親，糖尿病患者和Microsoft員工。 他是一位失敗的單口相聲漫畫家，一個玉米種植者和一本書的作者。
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翻譯自: https://www.hanselman.com/blog/the-extremely-promising-state-of-diabetes-technology-in-2018