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project</div> <style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox vevent"><tbody><tr><td colspan="2" class="infobox-image logo"><span typeof="mw:File"><a href="/wiki/File:Nightscout_Logo.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/8/89/Nightscout_Logo.png/80px-Nightscout_Logo.png" decoding="async" width="80" height="80" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/8/89/Nightscout_Logo.png/120px-Nightscout_Logo.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/8/89/Nightscout_Logo.png/160px-Nightscout_Logo.png 2x" data-file-width="192" data-file-height="192" /></a></span></td></tr><tr><th scope="row" class="infobox-label" style="white-space: nowrap;">Initial release</th><td class="infobox-data">2014<span class="noprint">; 11 years ago</span><span style="display:none"> (<span class="bday dtstart published updated">2014</span>)</span></td></tr><tr style="display: none;"><td colspan="2" class="infobox-full-data"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1257001546"></td></tr><tr><th scope="row" class="infobox-label" style="white-space: nowrap;"><a href="/wiki/Software_release_life_cycle" title="Software release life cycle">Stable release</a></th><td class="infobox-data"><div style="margin:0px;">15.0.2 / 28 November 2024<span class="noprint">; 2 months ago</span><span style="display:none"> (<span class="bday dtstart published updated">2024-11-28</span>)</span></div></td></tr><tr style="display:none"><td colspan="2"> </td></tr><tr><th scope="row" class="infobox-label" style="white-space: nowrap;"><a href="/wiki/Repository_(version_control)" title="Repository (version control)">Repository</a></th><td class="infobox-data"><span class="url"><a rel="nofollow" class="external text" href="https://github.com/nightscout">github<wbr />.com<wbr />/nightscout</a></span></td></tr><tr><th scope="row" class="infobox-label" style="white-space: nowrap;"><a href="/wiki/Operating_system" title="Operating system">Operating system</a></th><td class="infobox-data"><a href="/wiki/Linux" title="Linux">Linux</a>, <a href="/wiki/Unix-like" title="Unix-like">Unix-like</a></td></tr><tr><th scope="row" class="infobox-label" style="white-space: nowrap;">Available in</th><td class="infobox-data"><a href="/wiki/JavaScript" title="JavaScript">JavaScript</a></td></tr><tr><th scope="row" class="infobox-label" style="white-space: nowrap;"><a href="/wiki/Software_categories#Categorization_approaches" title="Software categories">Type</a></th><td class="infobox-data"><a href="/wiki/Medical_software" title="Medical software">Medical software</a></td></tr><tr><th scope="row" class="infobox-label" style="white-space: nowrap;"><a href="/wiki/Software_license" title="Software license">License</a></th><td class="infobox-data"><a href="/wiki/Affero_General_Public_License" class="mw-redirect" title="Affero General Public License">Affero General Public License Version 3</a></td></tr><tr><th scope="row" class="infobox-label" style="white-space: nowrap;">Website</th><td class="infobox-data"><span class="url"><a rel="nofollow" class="external text" href="http://www.nightscout.info">www<wbr />.nightscout<wbr />.info</a></span></td></tr></tbody></table> <p><b>Nightscout</b> is a <a href="/wiki/Free_and_open-source_software" title="Free and open-source software">free and open-source</a> project, and associated social movement, that enables accessing and working with <a href="/wiki/Blood_glucose_monitoring#Continuous_glucose_monitoring" title="Blood glucose monitoring">continuous glucose monitor</a> (CGM) data.<sup id="cite_ref-sparling_2014_1-0" class="reference"><a href="#cite_note-sparling_2014-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-jama_lee_2-0" class="reference"><a href="#cite_note-jama_lee-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Nightscout software aims to give users access to their real time <a href="/wiki/Blood_sugar" class="mw-redirect" title="Blood sugar">blood sugar</a> data by putting this data in the <a href="/wiki/Cloud_computing" title="Cloud computing">cloud</a>. In addition to browser-based data visualization, Nightscout can also be used to review data from a phone or <a href="/wiki/Smartwatch" title="Smartwatch">smartwatch</a>, or to remotely monitor CGM data for individuals with <a href="/wiki/Diabetes_mellitus_type_1" class="mw-redirect" title="Diabetes mellitus type 1">type 1 diabetes</a>. Associated with Nightscout software is a broader "CGM in the Cloud" social movement, supporting individuals seeking to access and use realtime CGM data through commercial and <a href="/wiki/DIY" class="mw-redirect" title="DIY">DIY</a> ("do it yourself") approaches.<sup id="cite_ref-facebook_3-0" class="reference"><a href="#cite_note-facebook-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="History">History</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Nightscout&action=edit&section=1" title="Edit section: History"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The Nightscout Project traces its origin to February 2013, when the parents of a 4-year-old boy newly diagnosed with type 1 diabetes began using a continuous glucose monitoring system. <sup id="cite_ref-sparling_2014_1-1" class="reference"><a href="#cite_note-sparling_2014-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-jama_lee_2-1" class="reference"><a href="#cite_note-jama_lee-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> This data was inaccessible to the parents when the child was at school – there was no commercially available way to access the data in real time. The boy's father, John Costik, a software engineer, developed software to access and transfer CGM data to cloud computing infrastructure. Costik shared his accomplishment on <a href="/wiki/Twitter" title="Twitter">Twitter</a> and, after others expressed interest, privately shared the source code.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2021)">citation needed</span></a></i>]</sup> </p><p>Costik's uploader was expanded by Lane Desborough and Ross Naylor,<sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> to develop "Nightscout": adding a blood glucose chart display that could be viewed throughout a home. Further development to make the software accessible to the general public occurred within a private community of developers, including Ben West,<sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> Ross Naylor, Kevin Lee,<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> Jason Calabrese, Jason Adams, and Toby Canning. Because this software was, in effect, an unlicensed medical device, the community delayed releasing the code as open source to explore and address legal concerns. Once this was done, the combined code was released in 2014 as the Nightscout Project.<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> </p><p>A website, <a href="/wiki/Facebook" title="Facebook">Facebook</a> group, and <a href="/wiki/Gitter_channel" class="mw-redirect" title="Gitter channel">Gitter channel</a> were also created to support new users.<sup id="cite_ref-facebook_3-1" class="reference"><a href="#cite_note-facebook-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> The primary Facebook group for the movement is "CGM in the Cloud", broadly supporting individuals seeking to use realtime CGM data, via commercial and/or <a href="/wiki/DIY" class="mw-redirect" title="DIY">DIY</a> methods. As of May 2017, this group has over 23,000 members. In addition, the related <a href="/wiki/501(c)(3)_organization" title="501(c)(3) organization">501(c)(3) organization</a> <b>Nightscout Foundation</b> was formed in 2014 to encourage and support open source technology projects for individuals with type 1 diabetes.<sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> </p><p>The #WeAreNotWaiting hashtag used by the group was initially coined by Lane Desborough<sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> and Howard Look, in reference to a growing call for a "diabetes data exchange" hosted by <a href="/wiki/Tidepool_(company)" title="Tidepool (company)">Tidepool</a> and <a href="/wiki/DiabetesMine" class="mw-redirect" title="DiabetesMine">DiabetesMine</a> in November 2013.<sup id="cite_ref-sparling_2014_1-2" class="reference"><a href="#cite_note-sparling_2014-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> </p><p>A survey of the Nightscout community indicated that the software was most highly used by parents of young children with type 1 diabetes (less than 12 years of age), but is also used by adolescents and adults. <sup id="cite_ref-diabetes_tech_lee_12-0" class="reference"><a href="#cite_note-diabetes_tech_lee-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Regulatory_concerns">Regulatory concerns</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Nightscout&action=edit&section=2" title="Edit section: Regulatory concerns"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Because Nightscout software displays information relevant to medical care, there are safety concerns regarding reliability, liability, and regulation. The United States <a href="/wiki/Food_and_Drug_Administration" title="Food and Drug Administration">Food and Drug Administration</a> (FDA) expressed concern that a singular entity was needed to review code, monitor safety, and respond to issues.<sup id="cite_ref-jama_lee_2-2" class="reference"><a href="#cite_note-jama_lee-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> As of 2016, no such entity had arisen, beyond the unstructured approach of community communication channels (e.g. Facebook group and Gitter channel).<sup id="cite_ref-facebook_3-2" class="reference"><a href="#cite_note-facebook-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-gitter_13-0" class="reference"><a href="#cite_note-gitter-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> </p><p>As a non-commercial open source project, Nightscout software has not been regulated by the FDA.<sup id="cite_ref-jama_lee_2-3" class="reference"><a href="#cite_note-jama_lee-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> The software is released with a strong disclaimer: </p> <style data-mw-deduplicate="TemplateStyles:r1244412712">.mw-parser-output .templatequote{overflow:hidden;margin:1em 0;padding:0 32px}.mw-parser-output .templatequotecite{line-height:1.5em;text-align:left;margin-top:0}@media(min-width:500px){.mw-parser-output .templatequotecite{padding-left:1.6em}}</style><blockquote class="templatequote"><p>Highly experimental. Not intended for therapy. Use at your own risk. Intended only as an investigational and educational tool to learn about this technology.</p></blockquote> <p>On November 20, 2020, <a rel="nofollow" class="external text" href="https://medicaldatanetworks.com">Medical Data Networks LLC</a> (Ben West, CEO) met with and formally petitioned the FDA for clearance of the service product “<a rel="nofollow" class="external text" href="https://t1pal.com">T1Pal</a>.” <a rel="nofollow" class="external text" href="https://t1pal.com">T1Pal</a> is a hosted Nightscout platform that runs copies of the latest Nightscout software on its servers for the benefit of individual subscribers. </p><p>Nightscout, when operated as a hosted service, is expected to enable many more people to use and benefit from Nightscout. <a rel="nofollow" class="external text" href="https://t1pal.com">T1Pal.com</a> charges a monthly fee to do this ($12.00/mo.), which includes technical support to set up and use the platform. <a rel="nofollow" class="external text" href="https://medicaldatanetworks.com">Medical Data Networks LLC</a> has asserted with the FDA that its implementation of <a rel="nofollow" class="external text" href="https://t1pal.com">T1Pal</a> meets all of the stated FDA requirements for code review, safety monitoring, and responding to issues. To support this view, a complete copy of the “Quality Management System” currently used by <a rel="nofollow" class="external text" href="https://medicaldatanetworks.com">Medical Data Networks LLC</a> was provided to the FDA. </p><p>The FDA generally viewed each operating instance of Nightscout as a "medical device" subject to labeling, hazard management, and FDA reporting requirements. <a rel="nofollow" class="external text" href="https://medicaldatanetworks.com">Medical Data Networks LLC</a> asserts that its product <a rel="nofollow" class="external text" href="https://t1pal.com">T1Pal</a> meets all of the FDA criteria for a "Class 2" medical device, and embraces needed FDA oversight and data reporting requirements. <a rel="nofollow" class="external text" href="https://medicaldatanetworks.com">Medical Data Networks LLC</a> is actively seeking to work more efficiently with firms that market CGM and other data so as to improve the quality and efficiency by which data is transferred into Nightscout. Nightscout's features for remote monitoring, data integration, and sharing are of immense value to the Nightscout community and merit continued support by the CGM device manufacturers.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2021)">citation needed</span></a></i>]</sup>. <a rel="nofollow" class="external text" href="https://t1pal.com">T1Pal</a> service adds to the Nightscout software patent-pending sharing features and standard email and phone support capabilities needed to enable access the largest possible community of users. </p> <div class="mw-heading mw-heading2"><h2 id="Commercial_alternatives">Commercial alternatives</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Nightscout&action=edit&section=3" title="Edit section: Commercial alternatives"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In 2015, subsequent to the development of the Nightscout Project, <a href="/wiki/Dexcom" title="Dexcom">Dexcom</a> released a CGM system that included 'Share', providing software for transferring data to cell phones via <a href="/wiki/Bluetooth" title="Bluetooth">Bluetooth</a>, and sharing CGM data with others via cell phone apps.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (November 2021)">citation needed</span></a></i>]</sup> </p><p>In 2017, the Spanish company Instead Technologies launched a continuous reading system named GlucoAngel for the <a href="/wiki/FreeStyle_Libre" class="mw-redirect" title="FreeStyle Libre">FreeStyle Libre flash glucose monitor</a>.<sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> </p><p>In 2020, <a rel="nofollow" class="external text" href="https://medicaldatanetworks.com">Medical Data Networks LLC</a> commenced commercial service operations, providing <a rel="nofollow" class="external text" href="https://t1pal.com">T1Pal</a> as "Nightscout in the Cloud" for $12.00/mo. The service is supported by email and phone support for paying customers. Beginning January 2022 the company added integrated support for <a rel="nofollow" class="external text" href="https://t1pal.com">T1Pal</a> combined with iPhone Loop services. This positions <a rel="nofollow" class="external text" href="https://medicaldatanetworks.com">Medical Data Networks LLC</a> as the first commercial provider of IT services needed to implement and support closed Loop operations. </p> <div class="mw-heading mw-heading2"><h2 id="Related_projects">Related projects</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Nightscout&action=edit&section=4" title="Edit section: Related projects"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The <a href="/wiki/OpenAPS" title="OpenAPS">OpenAPS</a> project has extended Nightscout to create a do-it-yourself "artificial pancreas", by automating basal insulin delivery by an <a href="/wiki/Insulin_pump" title="Insulin pump">insulin pump</a> to create a "closed loop" system.<sup id="cite_ref-commercial_support_17-0" class="reference"><a href="#cite_note-commercial_support-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Nightscout&action=edit&section=5" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-sparling_2014-1"><span class="mw-cite-backlink">^ <a href="#cite_ref-sparling_2014_1-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-sparling_2014_1-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-sparling_2014_1-2"><sup><i><b>c</b></i></sup></a></span> <span class="reference-text"> <style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output 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