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Getting Started with Your iLet Bionic Pancreas: What to Expect

Congratulations on ordering your iLet Bionic Pancreas!

Your iLet should be arriving shortly and your trainer will be contacting you to set up your training appointment.

What to expect starting on the iLet Bionic Pancreas

Whether you’re currently using multiple daily injections or a different insulin pump, the iLet Bionic Pancreas will be a bit different than your existing diabetes management. Here are some examples:

Here are some tips for using the iLet Bionic Pancreas:

Always have your CGM – the CGM readings allow the iLet to accurately dose insulin.

When in doubt, change it out – if you are trending high, you may have an issue with your infusion set, not the iLet. It’s always safer to change the infusion set to make sure you get the right amount of insulin.

Don’t forget to disconnect – always disconnect the tubing from your body while changing the cartridge or filling the tubing. This will avoid any extra insulin being dosed while you’re changing your insulin.

Don’t use any “outside” insulin – the iLet Bionic Pancreas will give you 100% of the insulin doses. If you take additional insulin (injections or inhaled insulin), you may risk going too low and confusing the iLet algorithms.

Try to avoid overtreating lows on the iLet – if your glucose goes low in the first 2 weeks while the iLet algorithms are getting to know you, try to avoid “over correcting” with too many fast-acting carbs.

We’re excited to train you on the iLet! If you haven’t been contacted yet to set up your training, please call 1-855-745-3800 and we can connect you with an iLet Clinical trainer.

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Congrats on Going Bionic – Tips for Starting on the iLet

Congratulations on Going Bionic with the iLet Bionic Pancreas!

Now that you have your iLet, you can help the iLet algorithms get to know you and your habits over the next 2 weeks. By giving it meal announcements, you’ll help the iLet learn you.

Just a few reminders as you get to know the iLet:

  • Be Patient – as the iLet gets to know you, you will still have some highs and lows. If you go low, you will still need to treat with rapid-acting carbs. If you are high, please acknowledge the alarm and check your infusion set.
  • Take Care of your iLet – the iLet needs to be charged, filled with insulin, connected to a CGM and connected to a working infusion set.
  • Disconnect when changing insulin – to avoid any accidental dosing, disconnect while changing your insulin cartridge.
  • Lows – remember not to overtreat a low. If you overtreat a low by taking too many fast-acting carbs quickly, it will give you insulin to treat the spike in glucose. The FDA recommends treating a low with 15 grams of fast-acting carbs, and then waiting 15 minutes to see if your glucose has come up. If not, repeat.*
  • Alerts – make sure to respond to the alerts.
  • When in doubt, change it out – if your glucose is running high, check your infusion set and change it out to make sure you’re getting insulin.
  • Meals Announcements – it’s best to announce meals when you sit down to eat. If it’s been 30 minutes and you forgot to announce, don’t announce at that time.
  • Supplies – always have extra supplies on hand.
  • Mobile App – make sure to sync with the mobile app so your physician has the most up-to-date information.

For more tips on how to be successful on the iLet, click on the Patient Success worksheet.

For more information, please click here to access the iLet Quick Reference Guide or User Guide.

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Meal Announcements Guide for iLet Bionic Pancreas

Meal Announcements with the iLet

Meal announcements are very important to help the iLet algorithms learn you. Here are a few tips on announcing your meals, especially in the first 2 weeks of using the iLet.

What do I announce? Only meals with carbs.

How do I announce?

  • Choose the meal type: Breakfast, Lunch, or Dinner
  • Choose the size: Usual for me, more or less.
  • Meal size is only based on the approximate carbohydrate content (not the total size of the meal, or the amount of protein, fiber, or fat)

Meal Announcement Guide

When do I announce a meal? 

  • Announce your meal right when you start eating. You can announce up to 15 minutes before your meal (if you do this, make sure to eat to avoid a low).
  • If you forget and it has been more than 30 minutes since you started eating, don’t announce.

Tips for using the Meal Announcement:

  • Don’t overthink it! Most of your meals will be “Usual for me”. If you need a little more insulin, the iLet will take care of it automatically.
  • Don’t announce rapid-acting carbs you used to treat a low.
  • Don’t use the meal announcement to try to correct for a high glucose level. iLet will correct for you.
  • Don’t change the size of the announcement because you want to get more or less insulin for that meal.
  • Be consistent with how you choose your meal type and size to help the iLet learn.

For more information, please click here to access the iLet QuIck Reference Guide or User Guide.

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What to do for Snacks on the iLet

You can use the Meal Announcement to announce snacks to the iLet the same way you would announce a meal – only if they have as many carbs as a meal.

Woman eating a banana

Choose a meal type – you can choose based on the type of snack, time of day, or whatever you find works best for you.

Choose a meal size – Compare the amount of carbs in the snack to the amount of carbs you usually eat for the chosen meal type.

  • Announce “Less” if the snack has about 50% of the carbs of your Usual for me meal for that meal type.
  • Don’t announce if the snack has less than one quarter (25%) of the carbs in your Usual for me meal for that meal type.
    • Low/no carb snack examples: protein (meat jerky, eggs, nuts, etc.), non-starchy vegetables (cucumbers, celery, etc.), and cheese.
  • Announce “Usual for me” or “More” if the snack is large and has as many carbs as your Usual for me meal or your More meal for that meal type.

Keep in mind that if there are several meal announcements close together, the iLet may not be able to learn from those announcements. For more information on using the Meal Announcement and how Meal Announcement doses adapt, refer to the Educational Resource Guide on the website.

For more information, please click here to access the iLet Quick Reference Guide or User Guide.

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Managing Highs on the iLet Bionic Pancreas

How to manage highs on the iLet

When you’re starting the iLet, you may still have high glucose levels as it learns how much insulin to give you based on your meal selections. It is very important that you let the iLet learn you and have it figure it out – by itself – that you need more insulin. We know sometimes it’s hard to “not do anything” to bring you back in range faster, but announcing a fake meal would confuse the algorithm and cause it to mis-dose your next meal. So please, please, please don’t do this! 🙏🏻

How does the iLet determine meal doses

When you announce a meal:

  • The iLet looks at the 4 hours after a meal announcement to determine how much additional insulin was needed or if insulin was suspended because your glucose went low.
  • The dose for that meal type will adjust up or down from there.
    If you announce an extra meal to treat the high, you will be at a higher risk for a low and the iLet will not be able to learn the correct dose.
  • During the first few weeks, it’s important to space meal announcements by 4 hours and avoid eating carb containing snacks between meal announcements to allow the system to determine the best dose for each meal type and size category.

When in doubt, change it out

If you are experiencing highs after the iLet has already learned you, you may have a kink in your infusion set. Please change out your infusion set to ensure you’re getting the insulin.

If you get the High Glucose Alert, your glucose has been above 300mg/dL for 90 minutes. DO NOT ignore this alert because it may mean that you’re not getting insulin. You should check that the iLet is functioning and the infusion site is working. Change the infusion site if needed and refer to your Ketone Action Plan.

If you experience prolonged hyperglycemia, follow your Ketone Action Plan and consult your healthcare provider.

For more information, please click here to access the iLet Quick Reference Guide or User Guide.

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How to Manage Lows on the iLet

When you’re starting the iLet, you may still have some low glucose levels as the iLet learns how much insulin to give you.

Your iLet will reduce or stop insulin dosing in response to low or falling CGM glucose levels.

If you go low, you will still need to treat with rapid-acting carbs, but it’s important to not take more carbs than needed. This can cause your glucose to respond too much, leading to a high glucose level and triggering more insulin dosing from the iLet.

Gummy snacks for low blood sugar

If you experience a low glucose level:

  • Check glucose level with a fingerstick blood glucose meter.
  • Treat with up to 15 grams of rapid-acting carbohydrates (or less) Your iLet will have likely already decreased and/or stopped insulin dosing.
  • Always wait and give your glucose level a chance to respond to the rapid-acting carbohydrates before treating again.
  • Check a fingerstick blood-glucose reading approximately 15 minutes after treating. Your fingerstick glucose reading may show a rise in glucose level before your CGM glucose rises.
  • Treat again with rapid-acting carbohydrates if your glucose level remains low.
  • Continue to monitor your glucose until it remains above 70 mg/dl.

If your iLet predicts your glucose level will be low soon, treat with some rapid-acting carbohydrates to try to prevent a hypoglycemic event from happening. You may not need the full amount of carbohydrates you would usually use if you were already low.

If you see your CGM glucose level dropping, but your glucose is still above 100 mg/dl, do not treat with rapid-acting carbohydrates right away. Monitor your CGM glucose levels and be patient.  The iLet has a fall rate alert that will let you know if your glucose is below 100mg/dL and dropping quickly so you’ll know it’s an appropriate time to take carbs,

REMEMBER

If you have the Low Glucose alerts turned on, the iLet will notify you and you can treat with rapid-acting carbs as needed. Keep all alerts on and at a volume where you can hear them. Set CGM app alarms to mirror iLet alarms.

For more information, please click here to access the iLet Quick Reference Guide or User Guide.

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Exercise on the iLet – Tips for Exercise and Insulin Management

When you exercise, your insulin needs can change significantly.

Your iLet does not know that you are exercising. Your iLet will continue to increase or decrease insulin dosing in response to your changing CGM glucose levels as usual.

exercise on the iLet

Always make sure to have rapid-acting carbohydrates available to prevent or treat hypoglycemia. Carry emergency glucagon with you to treat severe hypoglycemia.

Make sure your CGM alarms are turned on and the volume is set to a level that you can hear.

DO NOT pre-load with carbs while still connected to the iLet.

  • If you eat carbohydrates before exercising while still connected to the iLet, the iLet will automatically increase insulin delivery in response to your rising CGM glucose levels. This will cause you to have more insulin working in your body while you are exercising, increasing your risk of hypoglycemia during and after exercise – exactly what you were trying to avoid!
  • If you want to “pre-load” with carbs, make sure to eat your carbohydrate meal or snack AFTER DISCONNECTING from the iLet. This way, the iLet cannot deliver insulin and your glucose will rise from the carbs in the meal or snack as you intended.

Options during exercise:

  • Disconnect from the iLet
  • Make sure you can still monitor your CGM glucose and hear your CGM alerts.
  • Remember to reconnect to the iLet when you are finished exercising. Staying disconnected for too long can result in hyperglycemia and development of ketones.
  • Stay connected to the iLet
  • Do not “pre-load” with carbs to raise your glucose level.
  • Treat with rapid-acting carbs as needed.

For more information, please click here to access the iLet Quick Reference Guide or User Guide.

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Beta Bionics is a people-focused company dedicated to making diabetes easier for everyone, every day.

Safety Information – The iLet Bionic Pancreas System is indicated for use by people with type 1 diabetes 6 years of age and older. The iLet Bionic Pancreas requires prescription by a physician. Refer to the iLet Bionic Pancreas System User Guide at www.betabionics.com/user-resources, or for complete safety information including indications, contraindications, warnings, cautions, compatible devices, compatible drugs and instructions, refer to www.betabionics.com/safety. DO NOT start to use the iLet Bionic Pancreas System without adequate training. Incorrect use may result in over-delivery or under-delivery of insulin, which could lead to hypoglycemia or hyperglycemia.

Medical Disclaimer – This website is for information only and is not a substitute for medical advice and/or services from a healthcare provider. All personal health care decisions and treatment should be discussed with a healthcare provider who is familiar with your individual needs.

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