Has anyone on this forum tried the iLet pump yet?
I recently heard an interview on the podcast Diabetes Connections and it sounds like a potentially good option for our adult daughter who has an intellectual disability. I am mainly concerned with her future….when my husband and I (I am 70 and he is 80) are no longer able to assist our daughter with her T1D.
Of course, a completely artificial pancreas would be the ideal solution for her or better yet a cure (!!)
I just wonder if the iLet is a good option for someone like our daughter. I’m especially interested in its potential capacity to micro dose glucagon someday.
Has anyone tried it and been satisfied with it?
I tested this pump about 2 years ago. The glucagon option was on hold so I only just used the insulin delivery and algorithm.
The idea was no not take corrections and allow the pump to figure out everything. I was to only tell it, large med or small meal Which they at the time intended to get rid of at some point.
My control was horrible on this pump. I was out of range most of the time high, and it was just never going to work out for me. I was on it for 2 weeks.
The idea of glucagon microdosing was meant to be used with extra tight control, which if you have glucagon, you can do more safely.
However I was running with an average of 280, and so even if I had the glucagon option, it would have never been used on this trial because I was never low.
I hope they have improved it by now. I heard the current one still does not have the glucagon approved.
Hard to believe that it is a totally automatic delivery but I think they working to get there
I did a survey of “which pump” this year, no one said they were using the iLet. Someone on the BreakthroughT1D forum tried it and loves it.
Certainly sounds like it could be a good option next time your daughter needs new pump.
I don’t have personal experience with this pump, because I knew it wasn’t a good fit for me, but I’ve seen a lot of reviews and interviews with Beta Bionics. iLet’s target audience are first time pumpers, people who are overwhelmed by the burden of managing diabetes and willing to sacrifice control for ease, and people who really struggle to control their diabetes, regardless of pump experience. That might include your daughter, but I’m in no position to make that judgement.
When you compare iLet patient performance statistics to other pumps on the market, it comes in last place… though honestly, only marginally so. Even the CEO has flat said in interviews that it’s not for anyone worried about the numbers. It’s all about ease and simplicity. iLet users have more prolonged highs and more frequent lows on average because every bolus is a guess and the pump takes a while to figure out your insulin needs. You also can’t do anything if you’re not happy with it’s current performance. You’ve basically got to suck it up and be patient while it does it’s thing. That’s why experienced pumpers, especially successful ones, don’t like it. They’re not willing to sit there patiently and do nothing while the CGM reads “HIGH”. But still other people love iLet. It works really well for them and fits their needs, all with less mental burden than other pumps.
We don’t know anything about your daughter or her capabilities. Insulin pumps are a lot more to manage than MDI, with a lot more opportunities for malfunction and failure. Are you certain a pump is even the right choice for her? (It very well might be, I’m just playing devil’s advocate here.) Can she identify a failed infusion site, based on BG data and no response to bolused insulin, and make the decision to change it out before it results in DKA? Does she have enough attention to detail to manage the pump and it’s supplies? (No kinked infusion sets, no air in the cartridges/reservoirs/tubing, fighting with DME suppliers, keeping the pump and paired devices charged, etc…) She may not have to count carbs with iLet, but she is still expected to bolus dependably by going into the app and telling it she’s eating. Would it be simpler to use something like InPen, which brings pump features like bolus calculator and tracking insulin on board, to the MDI world?
We’re also on the verge of a lot of big advancements in the diabetes world. Maybe what you need is a short term solution or a backup emergency plan while you wait for something just a few years off. I know Tandem (T:slim/Mobi) and Insulet (Omnipod) are both working on fully closed loop algorithms that don’t require any bolusing or meal entry. I’m guessing the other players are, too. The Twiist o is being released sometime this summer with a pretty advanced algorithm, running Tidepool’s Loop. We don’t know a lot about the commercial version of Loop, which is different than the DIY version, but DIY Loopers have had success without bolusing using Loop. It might be a good option, too, if you decide a pump is the right choice. Tandem just did a study that showed people who didn’t bolus at all with Control-IQ+ were still able to achieve 68% time in range on average. (Don’t quote me on the number. Going off memory here, it was 60-something. Pretty sure 68%) I don’t have any data to compare that to other systems. I think we’re very close to getting GLP-1 RA (Trulicity, Ozempic, Weegovy, et all…) approval for T1s, which basically make the automated pumps work better by slowing carb absorption so it better matches with our insulin behavior and suppressing basal insulin need. Even the iLet you were initially asking about is due a big improvement in the near future when they get dual hormone approval. They might completely re-write the negative feedback with that update and become the top-rated pump.
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Thank you, Robyn_H. You bring up some very, very vital points.
Neither I nor my daughter (she will be 40 this year) would be happy with a pump that simply shows a reading of “high” and being powerless to do anything about it. She doesn’t like it all when her CGM lets her know she’s going high.
More important…you’re absolutely right about her capabilities—or lack thereof— in terms of all the aspects of pumping. She relies on me to do practically everything pump-related, from inserting the infusion set to any and all troubleshooting when things are wonky.
Although she needs me to do the carb counting, she is capable of bolussing or doing corrections when i tell her to, so she is able to navigate the basic functions of her Tandem pump. Nevertheless, she relies on me for pretty much everything else, including handling lows (she would way overdo the Smarties or glucose tabs without guidance). And then there’s the challenges of “troubleshooting” with insurance or suppliers….
It’s worth thinking about our daughter going back to MDI in the future. That had never occurred to me, to be honest. The pump makes her control somewhat better/ easier but may not be the solution when I’m not around to help her anymore.
Thank you for your incredible valuable input and perspective on this!
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I Seriously, considered the iLet, but the thought not being able to do any corrections for the weeks (months?) it takes for it to learn, was too much. So, not for me. If they incorporate glucagon and improve the learning time, maybe.
No one talks about Symlin any more. It’s an analog of Amylin, a hormone co-secreted with insulin from the beta cells. It smooths out excursions in the blood sugar. One of it effects is slowing gastric emptying.
It comes in a pen and is an extra injection at meal times. The dose is constant no matter how much one is eating. I never quite understood that, since it is co-secreted with insulin. I suspect they found the variations in the dose didn’t have much impact on the bg, so they simplified the dosing. It causes nausea in the first couple of weeks. For some it can be severe and last longer, but it does go away. I know at least one person who couldn’t get past that.
Unfortunately, it can’t be mixed with insulin or be injected in the same area. So it wouldn’t work well multi-hormone pump. Glucagon and insulin is a better pairing. If they make a formulation that can be mixed, then they could have three hormones in a dual pump. Can GLP-1 be mixed with insulin? Might make Symlin obsolete.
I was in the last trial before it was approved, and used it for years after that. Then I stopped using it for some reason. As I recall, something in my life style changed and it became more inconvenient. I tried to start again after some years, but I just couldn’t remember to put a pen in my pocket when I left the house, so I was using it for half my meals, at most. So gave it up all together.