Potential New Device

I’ve often thought that managing blood glucose is a little like doing algebra and basic math, and this takes away the mental burden of self-management and of continual self-monitoring:

The aim of the project is to democratize good glucose control, says Steven Russell, an associate professor of medicine at Harvard Medical School, who led the study.

“There are plenty of people who are struggling right now because they don’t have the right tools, and I think the iLet could help a lot of them have much better glucose control,” he says.

“This will reduce their risk of diabetes complications in the long run, and is also going to make their life easier.”

As for the functioning?

The device could remove the need for a person with diabetes to calculate the amount of carbohydrates in a meal, which is a significant benefit, says Duane Mellor, the lead for nutrition and evidence-based medicine at Aston Medical School, in Birmingham, UK, who was not involved in the study.

“Being able to take carbohydrate counting out of the equation is a really big advantage, because it’s a burden,” he says. “On the flip side, they have to relinquish control [of determining the insulin dose], which could be difficult for people who’ve had diabetes for a long time.”

Article describing:

The original study in the NEJM:


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This info uses a review and study published in 2022 about the iLet device that has since been released to the market by Beta Bionics. By providing technological insulin dosing help to most people with diabetes, the device can deliver substantial benefit to the group.

From the specific point of view from someone like me, this technology underwhelms, by wide margin. The iLet will help people with an A1c in the 7+% range and that achievement is absolutely worthwhile.

The attendant math associated with insulin dosing has never been a burden to me. I adopted a DIY algorithm based system, Loop, in 2016. My targets are “normal blood sugar levels” and I’ve lived with A1c’s in the 4.8-5.4% during that time. My lowered carbohydrate eating style provides an essential element to the success I’ve enjoyed. I worry, however, about the vagaries of aging and how I might maintain the critical element of normal blood glucose.

Beta Bionics readily acknowledges that it does not target people like me. I understand and respect their decision. I only wish that they would allow people like me to “earn” eligibility of a more aggressive form of their algorithm. I don’t see their strategic choice as “either-or” but could be a “both-and” choice that could help everyone. Maybe that’s how things will evolve but at my age I don’t enjoy the luxury of time.

An A1c of 7% is a large improvement from 8-10% but normal is south of 5.6%.

In summary, the iLet bionic pancreas is a huge technological move forward. It will help the most people with insulin dosing and significantly improve lives. I salute Beta Bionics while I still urge them to consider ways that could allow people with current A1c’s < 7% to benefit from their technology, too. We are a smaller, yet not insignificant slice of the demographic!


It will help a lot of people. So many are overwhelmed when first diagnosed with trying to learn carbs and insulin ratios etc. Teenagers who don’t want to learn dosing and want to be normal. People who are burnt out and just take a shot a day, if that sometimes. People that are just not good at carb counting and dosing and want the doctor to decide every step in their journey. Those are just a few of the ones that will benefit.

Honestly probably most of the type 1 population. It is really a small percent that even meet the goal of 70% TIR.

I know I have had to adapt off and on because of various things to my goal. Letting things slide more for a bit. But I am one of those that even with a 92% TIR for a couple of weeks, it drove me a little nuts. But as I get older knowing there are systems out there and that will make the decisions if I can’t, versus relying on an attendant at a hospital or care home is a huge blessing.

Even though my hubby who cares about me, he is not good at all with my tech or calculations. Frankly I don’t blame him. To get shown off and on and not have to do/use constantly is just one of those things you are going to forget… and then I change things so…


I was surprised when I saw that only 20% of the Type 1 population has under 7% A1c. I’m a slouch compared to many people in these forums, with my A1C’s in the 6.2-6.8% range, but have done so consistently for more than 20 years.

As @Terry4 mentions, it wouldn’t help someone like him, but many people would be helped, particularly newbies, as they have the hardest time getting the details worked out to maintain a decent A1C. Even then, the device would get improvements over time that might help in bringing the average A1C down further.


I find that even with a pump running automatic algorithm, I am faster and more precise tha it is. It’s good for sleeping because I’m not paying attention and I’m sleeping. During the day, I often will take extra bolus or pull back from the recommended bolus etc. glad I have a pump that allows this as Medtronic makes you turn off the algorithm to make these manual corrections. I would be fine with a pump that could do it so that I can not think about it. So far, I can do better.
Most diabetics on this site can also do better. But I agree that the broader type 1 community cant or won’t.