Are You Switching from Another Automated Insulin Delivery System to the iLet? The iLet is very different than the insulin pump you are currently using to take care of your diabetes. It is important to understand how it is different so you can be successful and safe using it to manage your diabetes. After you GO BIONIC there are a few important changes that will happen: The iLet will calculate and deliver 100% of your insulin doses The iLet will take care of all of your insulin dosing for you. Unlike other systems, you cannot program, change, or override the insulin doses the iLet gives you. This requires you to be comfortable with handing over control of your insulin dosing to the iLet. It can be hard to do this at first, especially if you are used to adjusting your insulin doses frequently. The iLet automatically learns and adapts to your insulin needs based on your CGM glucose levels. It will automatically increase insulin dosing when your blood glucose is rising or high and decrease (or even suspend) dosing when your glucose is dropping or low. You will still have high and low glucose levels on the iLet. Things like stress, food, hormones, and certain activities will still affect your blood glucose. You need to be patient and comfortable with allowing the iLet to respond to your changing glucose levels. However, you should always respond quickly to alerts, including treating lows with rapid-acting carbohydrates. Remember: iLet alerts tell you when you need to do something to keep the iLet working, or keep you safe. Avoid overtreating your lows. If you use too many carbohydrates to treat a low, it can cause a high glucose. The iLet will give you more insulin, and then your glucose may go low again. This pattern is called a “rollercoaster” effect. DO NOT take insulin outside of what the iLet is giving you without help from your healthcare provider. There is no way to tell the iLet that you took an injection. Doing this can lead to “stacking” insulin (having too much insulin in your body), which can cause a severe low blood glucose. Your job is to keep the iLet working and help it learn your insulin needs DO NOT confuse the iLet. You need to give the iLet accurate information. You may have learned habits or “tricks” to help you get better glucose control on your current system. Trying to apply these habits to the iLet will not work and can confuse it, causing it to adapt in a way that is not safe or makes your glucose control worse. • EXAMPLE 1: Announcing meals to correct a high glucose. You may be used to entering “ghost” or “fake” carbs to get your system to give more insulin. If you announce a meal to the iLet without eating to try to correct a high glucose, you can have a severe low blood glucose because the iLet is already giving you insulin to try to bring your glucose down. It can also teach it to give you less insulin for that meal type. Next time you announce that meal type, it may cause the dose may be less effective and lead to high glucose levels. EXAMPLE 2: Announcing your meals as smaller than they actually are to try to get less insulin from the iLet. If you are eating your “Usual” meal size but decide to announce it as “Less” to try and get less insulin, it can actually teach the iLet that you need more insulin for that meal type. This usually causes the iLet to adapt that meal does upward, meaning you could get more insulin than you need the next time you announce that meal type - causing a low glucose. Keep the iLet working so it can give you insulin and manage your glucose levels. • Make sure your iLet has enough battery, has enough insulin, is reading your CGM glucose, and your infusion site is in place and working. Change your insulin cartridge, iLet Connect, tubing, and infusion set on time or if there is a problem. Respond to iLet alerts right away! ALWAYS DISCONNECT the tubing from your body before changing your cartridge or filling the tubing. If you have the tubing connected to your body when changing the cartridge or filling the tubing, you could push a lot of insulin into your body that you don