Wearing your pancreas on your wrist….

Wearing your pancreas on your wrist….
professor freeman diabetes research

We’ve all head of the old adage, “Wearing your heart on your sleeve”, but how many of us can say the same about our Pancreas?

While continuing the #WeAreNotWaiting tradition of trying out new things, I obtained a Lemfo Lem12Pro running Android 10 in order to see if it was possible to run AndroidAPS 2.8.2 on it, as it requires a minimum level of Android 8.

Setting up the watch

It turns out that with the default settings on the watch, that’s nigh on impossible, but there is a helpful app on the device that allows you to remove apps from the battery saver process so they can run in the background. By disabling that for AAPS, the Dexcom BYODA and xDrip, you can get a functioning wrist pancreas (That’s in the Optimiser App, Clean Task option). You also need to remove the apps from the OS battery management.

So there’s a bit of set up to do, but it’s as easy as downloading the apps, entering passcodes and installing preference files, and starting them up, and then making the adjustments.

So with all of this set up, the Dexcom app running, and AAPS communicating nicely with my Roche Insight pump, we were all set to test it out.

How well does it run?

Remarkably well. I’ve not seen much in the way of loss of Dexcom data. It’s not complained about the pump being unreachable, and it continues to run while being charged. If you leave WiFi on it will upload happily to Nightscout, or you could put a SIM in it to do the same thing, in which case you would then be able to receive the data on another device if you so chose.

I use Square Screen mode, as you can see more of the AAPS interface that way. For the way I use it, which is not to enter carbs and only give insulin using UAM, it works very well. I imagine the bolus wizard is a little more tricky, but I don’t use it. You can see the effect of trying to use it in the video below:

What are the issues?

Battery Life

Well the most obvious one is the battery life. It lasts a little 12 hours on a single charge,

For those of us who are able to sit at a desk all day, and have an opportunity to charge it while doing so, that shouldn’t be a huge issue as the loop continues to run while charging, but it maybe frustrating to others. Whilst charging, the device does seem to have a decent range, so you can sit and watch TV whilst it’s charging 3m away

I’d add to that that in order to get to 12 hours, Wi-Fi or Mobile Data was disabled, and the lift to wake function was also disabled, so I had to press a button to see glucose levels. That’s somewhat frustrating.

Enabling data sharing or enabling lift-to-wake will both deplete that battery life, which is the major commodity in using something of this size.

Additionally, there is a setting for brightness that can be turned down to as low as you are comfortable with, which will also help the battery life.

Of course, if you want notifications from your phone, or exercise capabilities, there are ways to set these things up with the “pancre-watch”, but every additional piece of connectivity or sensor use will drain the battery faster, so it’s a trade off you have to work out for yourself.

There’s also the question of whether the activity focused side of watches like these is really good enough to compete with devices such as a Garmin or Fitbit. I can easily see myself ending up wearing two watches…

Form

This particular watch is also “not very waterproof”, so I wouldn’t want to try and use it in any form of activity that might result in it getting wet.

Then, of course, there’s the screen size. With a 1.6″ screen, you don’t have much real estate, so it’s not ideal. You can see how it functions in the video, and for some that would be deal breaker. However if you’re the person who only interacts with the app when you need to deliver insulin, it’s probably not so bad. For me personally, it took a bit of getting used to.

The other issue for some will be the overall size of the device. I’m a 6’4″ man with fairly large wrists, so it’s not too out of place on me, even though the watch does stand 15mm off the wrist. If you’re smaller than that then it’s going to pose more of a challenge.

What’s good?

It’s a very small device on which to run AndroidAPS if you don’t have an Android phone. That has to be a positive. It’s also much more convenient in relation to most forms of exercise or activity. There’s never any need to stash a watch in a pocket or back pack. And with 12 hours of battery life, it should last long enough for most types of activity without requiring a recharge.

So what we’re saying here is that the key benefits are form factor and convenience.

Alternatives?

There are other watches that run the same firmware, but with larger batteries and similar hardware, as listed below:

Watch Battery size Comments
Lemfo Lem14 1100 mAh Same size as Lem12 Pro with large battery
Lemfo Lem15 900 mAh Same battery as Lem12 Pro, with newer chipset
Kospet Prime 2 1600 mAh 2.1″ screen, so very large on the wrist
Kospet Optimus 2 1260 mAh Similar size to Lem12 Pro but with larger battery

In the marketing blurb, the only one of these that claims any kind of waterproofing is the Lem14, so that would appear to be possible the most sensible to try, although I would take it with a pinch of salt. What’s worth being aware of is that all these devices run with te same firmware, so they should all be capable of doing this.

Overall, would you recommend this approach?

It depends. Not with this particular device. With a larger battery, and maybe 16 hours of life, or perhaps lower with some of the features I’ve disabled turned on, it’s a much more exciting prospect. It allows a good way to run AAPS, especially if you’re an iPhone user who doesn’t want to jump on FreeAPSX just yet. It’s also way better than lugging your phone with you for certain types of exercise.

Overall then, I’d give it a guarded thumbs up. If it fits your use case, and you can do this on one of the alternative devices with a larger battery. It works surprisingly well, and after the initial culture shock of not doing it on my phone wore off, I’m quite surprised at how I’ve become much more accustomed to it. I may try on one of the devices with a larger battery, and then perhaps I can revert to the iPhone for my every day phone use!

Can you wear your pancreas on your wrist? You most certainly can.

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