Update on the iLet (bionic Pancreas)


#21

When I first read about automated insulin dosing systems using a variable basal rate to control short term blood glucose, I was skeptical. What I’ve learned so far is when glucose and insulin are balanced well in the moment, a shift in basal insulin up or down has a surprising glucose influence in the near term.

I don’t know how this happens given the sub-q delivery path and the relatively slow onset and peak of rapid acting analog insulin. It reminds me of the tremendous forces that a heeled over yet well-trimmed sailboat balances and leaves the wheel at the helm as light as a feather to steer.


#22

Just as you need both a gas pedal and a brake to drive a car smoothly, so too in controlling blood sugar smoothly, you need both insulin and glucagon.


#23

Everyone is entitled to their own opinion. If someone feels this is not in his or her best interest then by all means they will not be required to partake.

I see this system as allowing PWD to live a more normal life, a life less structured if that is what they wish. There is no right or wrong, I believe a person should have a choice if choice is possible. Hopefully this product will provide choice.

Hopefully one of the the choices will be good control where there has never been. Hopefully there will be a healthier life for those that, despite their best efforts, have been unable to achieve tight control.

I see this system as a game changer for PWD that need it or want it. I believe it will make a difference, but then I usually do see the glass as half full.


#24

Glucagon function is not totally normal in pwd and gets worse over time. If it were totally normal we wouldn’t need sugar to raise our bg etc.


#25

some people have one foot on the brake, at the same time they have their other foot on the gas. that’s a good way to ruin the brakes, and reduce mileage. I once worked at a dealership where a customer kept complaining that his brakes were wearing out VERY prematurely. After yet another brake job (warranty, no less), the manager decided to go for a ride with this guy. Turns out–you guessed it–he rode the brake pedal with his left foot. No more warranty repairs for brakes,for him! :slight_smile:


#26

Agreed, Gary, and I always do SO MUCH BETTER when I eat a proper (for a diabetic) diet. Less insulin, less lows, less hassle. OR, I can eat everything I want, but expect wild swings in my bg’s. My choice. Others will choose to expect a pump with “push/pull” technology with tubing running all over, to keep them in a safe range. Funny how the much touted 670 hasn’t managed to live up to that expectation, given that it is called a Hybrid closed loop pump. People get it, expecting miracles. turns out, it’s more hassle than what they expect. The Auto Mode isn’t what it’s cracked up to be. I FULLY expect and PREDICT that the iLet will be yet another pump long on promises and short on delivery. If this post still stands when it comes to market, and I’m still a forum member, I’ll point to this post and let everyone decide who was right. :slight_smile: At that point, it won’t be about opinion, as much as it will about the facts of the actually ability of a pump to normalize a T1’s glucose levels. I predict it will not.

And, let’s say that it is the first of the “Holy Grail” of pumps. Will it be affordable, given the cost of it’s sensors, sets, insulin, and Glucagon for the average person using either private insurance, group insurance, NO INSURANCE!, or government coverage such as Medicare in the US, NHS, etc in other countries? (sorry for the long sentence.)


#27

Clearly, that will be a hurdle to overcome. Just thinking about stable glucagon, my concern is there is one in trials at the moment, but it’s not approved yet; plus how big is the market going to be for it - certainly the definition of a niche, right?

I remain very hopeful that the iLet hits the mark.


#28

I too would love to see a great management tool that outshines all others to date. But I’ve been hearing about this stuff for so long it’s not possible for me not to be jaded.


#29

Thanks for posting the info Mila!
This is the one I am waiting for! I have been watching this one from when the volunteers were hooked up to a computer in a hospital and a person sat with the patient through the whole time to make sure things went as planned. And than it went out into the Boston wilds with a nurse following the people and was the backup again. Than they went to summer camp! Summer camp where they let children wear them while running round summer camp. The numbers have been fantastic! And you don’t need to carb count and pre bolus. Just enter your weight and whether it is a small, regular or large meal, and the system learns. I can’t wait. When I see the numbers this pump is putting out, it makes me want to cry. Cry for all the years I struggled with the one shot a day or five shots a day or exchange diet or urine testing. I am so thrilled it is getting closer! I am hoping and praying my research center will be a site soon! I am all in on this one!


#30

I couldn’t do the exchanges. Not until I got a pump and did carb counting did I have any semblance of control. Whoever dreamed up exchanges should be ashamed. :slight_smile: j/k, but it wasn’t for me.


#31

Guys, just to clarify, they are trialing TWO versions of the iLET - a dual hormone (insulin, glucagon) version as well as a SINGLE hormone version (insulin only).

The SINGLE hormone version is expected to get to market first.

You will have a CHOICE.


#32

This is wonderful! I keep reading about Looping and am so interested, but then get intimidated by the set up…I feel like I’d need a couple of weeks to devote to starting up. Was that true for you?


#33

@Lucia – Let me start by saying that a do it yourself automated insulin dosing system is not for everyone. That being said, you don’t have to sport a deep background in technology and computers to join this community. What you really need are patience and the ability to follow written directions. Many people, with little technical expertise, continue to join the ranks of the DIY community.

The Looped Facebook group is deep with experience and an abundant willingness to help. They are there around the clock and want to help.

I started with someone’s kind offer to lend me a compatible pump to get started. This person also acted as a mentor to get me started. I assembled the materials to get started with OpenAPS but I changed my direction when Loop, an Apple based system, became available. I’ve since located my own compatible pump and have added a back-up pump as well.

The hardest part of DIY looping is finding a compatible pump to get started. Yet people are coming online every day. There are older pumps out there waiting for you to find them. If you are interested and willing to put in the work, I’ve no doubt that you can make it work for you.

If you are a person that requires a warranty and an 800 number to call for help then DIY looping may not be for you. If you want to spend as little time as possible on your diabetes and instead want to focus only on the “rest of your life,” then you may not be suited to this project.

I am so happy I took the risk. When I see people struggling to make the MiniMed 670G to work for them, I count my blessings. Loop and OpenAPS are both at least five years ahead of the current commercial systems.


#34

I’m using the 670g and I can tell you I would benefit greatly from having glucogon w/ it. I still experience lows- physical activity especially is still hard for me. I’d love to workout and not have to stress out about my bg going low OR have to carb load. If you ever listen to the juicebox podcast Seth actually interviews a woman who was in the early phase trials and she said having the glucogon was game-changing for the better! I think it’s like episode 46 or 48.


#35

Thanks @Terry4. I actually have a 522 Medtronic pump, and was using it til I started on pods recently, which I’m preferring… so that’s part of what’s kept me from starting in the Looping world. I know I will at some point, from all I’ve read, just waiting for the right time! I already use the sugar surfing method, so I spend a lot of time looking at my CGM… thanks!


#36

Wait, you have one of those magic pumps! Sitting there with you right now! Begging you to just give it a try! Whispering in your ear, give me another chance. I can make magic for you!
Just kidding about the whispering but my old MiniMed is a 508which is useless. And the Medtronic users I know don’t have the right one or do want to let go of their back up. So I wait.
And I was just in yesterday for a follow up to a current trial I’m doing and asked about the Beta Bonic trial. Because as I’ve said many times, this is the one I’m waiting for. The 2 centers listed are doing the first group. That is usually the safety and procedural study to see what works and what doesn’t. Thankfully my research center has the money and is ready to go, just waiting on clearance to start. Looking at next year. And yes to get it to market faster, it will probably launch with just insulin, glucagon can be added later.
Every time I think about a system that removes all the thinking I have to do day in and day out, I get so excited. I am so ready to not have to think about everything I do. I can’t wait!


#37

When/if you decide to use your 522 in a looping system, you may be interested in reading this OpenAPS vs. Loop comparison review written T1D teen mom, Katie DiSimone.


#38

wow–way too technical for me! I’m good with my 551 & G5,but thanks for the link,Terry. I HAD to look at it a bit, but after 20 or so technical paragraphs of what one does to loop (whatever that means), I did the sensible thing, and closed the webpage before my eyes rolled back in my head.


#39

I understand. These systems are not for everyone. It’s why the commercially produced automated insulin dosing systems will always have an appeal for some people. It’s nice to have choices.

I remember when I got my first pump back in the '80s. When I showed it to interested people, I often received the comment, “you must have the bad kind of diabetes!” People couldn’t imagine making that level of complication a part of your daily life. Those first pumps that I used were closer in technical concept to a syringe and vial than today’s systems like Loop.


#40

I remember the pics of Autosyringe. and the pump that was carried like a backpack!