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jjlengelbrecht about 8 hours ago 36 commentsRead Article on github.com
I'm a Type 1 diabetic and software engineer. Last year I went months between endocrinologists with no clinician reviewing my data. I'm an engineer, so I built the tool I needed — and now I'm open sourcing it. GlycemicGPT is a self-hosted platform that connects continuous glucose monitors, insulin pumps, and existing Nightscout instances to an AI analysis layer running on your own infrastructure. Data sources:

Dexcom G7 (cloud API) Tandem t:slim X2 and Mobi pumps (direct BLE) Nightscout (point it at your existing instance and you're running in minutes)

What the AI layer does:

Daily briefs summarizing overnight and 24-hour patterns Meal response analysis Conversational chat with RAG-backed clinical knowledge Predictive alerting with configurable thresholds and caregiver escalation

Important: this is monitoring and analysis only. GlycemicGPT does not deliver insulin, does not control your pump, and is not a closed-loop system. It reads your data and gives you insight on top of it. Your clinical decisions stay between you and your care team. Architecture:

Self-hosted via Docker or K8S — the GlycemicGPT stack runs entirely on your hardware BYOAI — bring your own AI provider. Use Ollama for fully local operation (no data leaves your hardware), or point it at Claude, OpenAI, or any OpenAI-compatible endpoint if you prefer a hosted model. Data flows directly from your instance to the provider you choose; nothing is routed through any centralized service operated by the project. GPL-3.0, no subscriptions, no vendor lock-in

Stack:

Backend API: FastAPI, Python 3.12, PostgreSQL 16, Redis 7 Web Dashboard: Next.js 15, React 19, Tailwind CSS, shadcn/ui AI Sidecar: TypeScript, Express, multi-provider proxy Android App: Kotlin, Jetpack Compose, BLE Wear OS: Kotlin, Wear Compose, Watch Face Push API Plugin SDK: Kotlin interfaces, capability-based, sandboxed

Looking for contributors — especially folks with BLE/Android experience or anyone in the diabetes tech space. Plugin SDK is documented if you want to add support for new devices. GitHub: https://github.com/GlycemicGPT/GlycemicGPT

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Discussion (36 Comments)Read Original on HackerNews

mhovdabout 3 hours ago
The risk to benefits ratio of introducing a language model to interpret so clear signals is nowhere near justified.

Monitoring and analytics is important, but it is a solved problem. A language model will only be able to hallucinate about the relationship between meals and glycemic response. At best it does no harm, at worst it can directly misinform.

pimeysabout 2 hours ago
Yep. The oref1 algorithm is amazing and proven to make diabetic's quality of life better, AND SAFE. I don't understand why would you need to add AI to that mix.

But I will check this algo out. Maybe it has some interesting bits.

wg0about 2 hours ago
Thanks for calling out!

We're even yet debating and trying to understand what impact AI has on software engineering and quality let alone putting AI into something that's directly linked to a human's well being.

nonameiguess27 minutes ago
That's just risk/benefit to the user. As the developer, I'd be concerned that publicly distributing and marketing this, even with a GPL "no warranty" license and even free to the user, is illegal.
AnthonBergabout 2 hours ago
My experience is completely the opposite, of using LLMs to pattern match and cast diagnostic nets.

Is your perspective based on, say, opinionated principle?, or experience?

The benefits are enormous.

The risks; What risks? No diabetic with baseline adult competence is going to drive their insulin-delivery vehicle off a cliff because some app said so.

pferdeabout 2 hours ago
I think you're being too optimistic about your fellow humans' judgement. "Death by GPS" is a quite common occurrence: https://www.sciencedirect.com/science/article/abs/pii/S13550...
AnthonBerg21 minutes ago
Type 1 diabetes with the sensors and pump technology that this software being presented here fits to is not Everyman Joe stuff. Someone who can set this up and get this going is already burdened with the kind of analysis that the app can assist with.
andersonpicoabout 1 hour ago
> No diabetic with baseline adult competence is going to drive their insulin-delivery vehicle off a cliff because some app said so.

if you can't trust this thing then what is it doing? the implication that people that trust this software do not have adult competency is also confusing.

> Is your perspective based on, say, opinionated principle?, or experience?

your perspective is solely based on recent trauma so I don't know if it is more reliable in any capacity

AnthonBerg9 minutes ago
Don't trust the thing. That's not what it's for.

Don't do as I say. I'm just a rando from the Internet.

Don't do as the author of the posted software does. Don't do what the software tells you either. But the software can certainly build an informative perspective and suggest patterns and movements in an exquisitely complex disease. Managing T1D with a pump is exhausting.

Second, re. "your perspective is solely based on recent trauma so I don't know if it is more reliable in any capacity"

This kind of statement is far beyond anything bounded by the self-respect of a balanced adult. What the fuck, and who are you?

My ex-fiancée almost died in 2020. We lost an unborn child in IVF due to grave neglect on behalf of healthcare who missed the glaringly obvious Type 1 diabetes she had; They never once checked her blood sugar. You know what I did? I read the literature. I read medicine, I read molecular biology, I read neuroimmunobiology, I read about the placenta and fetal development.

I stood by my fiancée and carried her by hand back to health. She recovered faster than the endocrinologists expected. Her pregnancy was exemplary, fullly intact placental vitals out to 38.5 weeks. Healthcare is in such a bad state that I was forced to interject and argue coolly and adamantly with doctors on several occasions about potentially severe mistakes they were about to make. EVERY SINGLE TIME when I interceded, it was confirmed correct by a second opinion from a senior doctor.

I don't come here speaking from trauma. I come here speaking from grim and serious and confirmed lived experience of stepping in and caring, without any margin for error. Know how you do that? With extreme humility and the utmost care.

Who are you to speak to me like that; I can tell that you know not at all who I am or what I have been tasked with in this life, because then you would not. talk. to me. this way. Okay?

conspabout 1 hour ago
> The risks; What risks? No diabetic with baseline adult competence is going to drive their insulin-delivery vehicle off a cliff because some app said so.

My local physician says otherwise, with respect to facebook posts about dosages. I'm convinced the same applies to LLM generated content with respect to people blindly following the computer.

AnthonBerg5 minutes ago
I ask for your understanding in that I chose to have "baseline adult competence" highly load-bearing in my comment. This does not include people who have only such poor judgement to guide them that they use Facebook posts as input to managing their T1D pump/sensor-based management.

It is entirely possible to beneficially and safely use software like the that which is the topic of the post.

pu_peabout 1 hour ago
Risks:

Changing parameters on the insulin pump because the LLM said so

Neglecting to seek actual medical advice believing a LLM replaces it

Misunderstanding medical complexity (ie a prescription due to medical history not available to the LLM)

mexicocitinluezabout 1 hour ago
> No diabetic with baseline adult competence is going to drive their insulin-delivery vehicle off a cliff because some app said so.

You 1000% don't work with the general public in a tech way.

AnthonBerg23 minutes ago
"Baseline adult competence" was load-bearing there.

This is not an app for the general public.

peppetv415 minutes ago
Really nice of you to share this, well done!

About the risks, managing type 1 diabetes is exhausting, and most people will still sanitycheck the output alongside the hundreds of treatment decisions they make every day. That doesn’t change the fact that tools like this can nudge you to notice and look into patterns or things that needs attention.

surgicalcoderabout 4 hours ago
I'm a T1D who has an insulin pump looping with AndroidAPS and NightScout, what does this give you that Nightscout and Autotune doesn't give you?

And how do you deal with AI hallucinations?

pimeysabout 2 hours ago
I think the only thing that could be made better is tuning the I:C/ISF/Basal values automatically. And ISF is already handled by DynamicISF, while not perfect it reduces the variables you have to tweak.

Otherwise, when tuned correctly, oref1 et.al. provide amazing results and are safe. Hard to understand where I would use LLMs in this.

surgicalcoderabout 1 hour ago
You sort of have that - not automatically though, but you can run autotune against nightscout and get a report of where things need to be adjusted. I run oref1 with DyanmicISF, and just run autotune every few months just to tweak values.

I genuinely don't see where I would use an LLM in this process.

sexylinuxabout 1 hour ago
You know that current AI systems are not reliable and produce errors?

How do you protect your life and the life of others using your software against potential lethal errors?

darkhorse13about 1 hour ago
This is quite possibly a horrible idea. Personal anecdote: ChatGPT once read a blood work report value as 40, when the actual report said 4.
tornadofartabout 3 hours ago
I'm a T1D and tbh it's not that hard to manage, I just wouldn't need that. But for kids or the elderly, I see a use case.

The hardest to learn was that an unhealthy lifestyle resulted in a diabetes that was harder to manage. Too much carbs, not enough exercise, etc. After adjusting my lifestyle, it became quite easy.

The most pain, in my experience, comes from the discrepancy between the CGM - measured value and the prick-test value, even when accounting for time lag. I've used several CGMs and they've all been wildly off sometimes. I have a few T1D acquaintances who relied on their CGM alone and have significantly improved their HbA1c after accounting for that.

Maybe that information is useful to you.

jevogelabout 1 hour ago
Look into Eversense 355 (implantable), it has so much better accuracy for my wife than the Libre and Dexcom CGMs she has tried.
throwatdem12311about 1 hour ago
I mean this in the nicest way possible.

But if someone dies because this thing hallucinates their reporting - would you feel any sense of culpability?

“GPL says no warranty”

“People need to double check LLM output”

“You’re holding it wrong”

I really don’t know if we, collectively as a civilization, should be willing to accept this kind of hand-waving when it comes to creating things like this. Sure, tools make mistakes or people misinterpret reports without the help of LLMs - but LLMs are just on a whole other level where the mistakes are just part of how these things work from a fundamental level.

I don’t even trust AI scribes at my doctors office to transcribe my appointment due to errors. There is no way in hell I would ever use something like this that could just straight up lie about something that kills me if I get it wrong.

vsaravind007about 2 hours ago
Looks interesting, being a Whoop user for the last few years, I have seen for myself that their AI Coach/AI based suggestions are a hit or miss 3 out of 10 times, slightly concerned about how accurate this will. Not a diabetic patient, but I do monitor my levels with a CGM from time to time, will definitely check it out!
hombre_fatalabout 1 hour ago
The issue with Whoop’s AI is that there isn’t much data, and the data doesn’t have much prescriptive power, so it can’t really suggest anything useful. Recovery and Strain scores are made up, and even resting heart rate doesn’t tell you anything prescriptive for the day.

The data available to the LLM in OP’s app is the polar opposite. It’s all actíonable and real, so I bet it can draw more useful insights than Whoop reminding you that you didn’t exercise all week.

AnthonBergabout 2 hours ago
Went through pregnancy with the mother having recently-diagnosed T1 diabetes – just barely not killed by grave neglect on behalf of healthcare due to how badly they missed the diagnosis to begin with.

On your work:

this is legit

it is appreciated

Hats off, I salute this, thank you

axegon_about 3 hours ago
"This will all end in tears, I just know it"

Marvin

foo-bar-baz529about 3 hours ago
What’s the limit on badges in a README
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MassiveOwlabout 2 hours ago
I've done this with the Libre 2 sensor. I added Gemini to it. It gets like 2 weeks of readings at once, and the user can "chat to their data". I added a meals tool as well, where the user can photo their meal, and the ai estimates the impact on the readings.

It's so helpful to offload some the thinking about the condition to ai, all these people moaning about 'muh safety' don't get it. T1D suffers have to think about it all day all the time. A person doesn't have their own blood glucose data in their head.

xyzalabout 3 hours ago
This is THE ONE domain where you would want to use classical machine learning and not unreliable LLMs. Unless you want to kill yourself, that is.
stingraycharlesabout 3 hours ago
Yes, language has nothing to do with it and is complete overkill.

Probably something like SVM for warnings.

Unless the whole purpose is just daily reports.

fnandsabout 4 hours ago
The alerts system and sharing with caregivers is a solved problem already (e.g. Dexcom's Follow, Abbot's LibreLinkUp).

Do you find the analytics actually helps? I.e. a lot of this will depend on what you ate and whether or not you logged it?

andaiabout 3 hours ago
Life imitates comedy...
maleldilabout 2 hours ago
I'm just happy to see a GPL project.
mexicocitinluezabout 1 hour ago
So, I'm in the medical field building an EMR and LLMs have obviously been a really important topic in the industry the last few years. We're still not even sure that giving LLM-assisted suggestions TO ACTUAL DOCTORS AND CLINICIANS will be helpful let alone to the patient themselves.

It's breaking the golden rule of these tools which is to have someone with enough knowledge to verify the accuracy of the data it spits out. Patient's famously don't. Hell, even the actual staff don't really understand or know how these tools work (or the ways in which you can/can't trust them).

emsignabout 2 hours ago
FDA approved?