Future of the Bi-Hormonal Pump & How it Works

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I spoke with Ed Damiano, founder of Beta Bionics, about his work on the bi-hormonal pump that uses glucagon and insulin to control blood glucose levels. We get into how the algorithm is superior to other AIDs, the results expected and what it will be like wearing it. Drop your thoughts and questions in the comments ⬇️
Watch Next:
• Beta Bionics iLet Pump...
• Wearing the Beta Bioni...
• Beta Bionics CEO Inter...
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DISCLAIMER: This podcast is not medical advice. Always consult with your doctor before making changes to your health care.
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Chapters:
What is Glucagon? - 7:40:08
The Bi-Hormonal iLet - 12:40:16
Benefits of a Using Glucagon - 16:38:07
The Results - 26:53:03
How iLet Automates Insulin - 29:57:01
Evolution of the Bi-Hormonal Pump - 34:05:08
How it's Worn - 42:42:03
Next Step, Pivotal Trial - 50:50:07
Xeris x Beta Bionics - 54:47:08
-- Product Link Disclosure -- In order to create free content, I use affiliate links. This means if you make purchases through certain links, I may earn a small commission (at no extra cost to you).

[@anthonyshelley6083]

Ive been on the Ilet almost 2 months. There is a learning curve ans some highs at first, but once it learns you it is amazing. I see so many people not giving it time. Definitely excited for the bihormonal, but even without I love it already

[@user-dp6dt3jd2v]

I would like to use bi-hormonal pump. The episode on bi-hormonal insulin pumps was incredibly insightful! The potential of these devices to transform diabetes management is truly exciting. The ability to mimic the natural pancreas more closely by delivering both insulin and glucagon could revolutionize treatment, making blood sugar control more stable and reducing the risks of both highs and lows. The conversation about the ongoing research and the hurdles still to overcome was particularly engaging. This technology holds so much promise, and it's inspiring to hear about the advancements being made. Keep up the great work with these informative episodes!

[@kristinsands2027]

I love the iLet. 5.5 months in so far. While I could manage about 70% TIR with a 6.3% with my previous pump, I am now having about 80% TIR with the SAME HbA1c. I can do the math, but I love not having to. I can micromanage changing basal settings, but I love not having to. I think I have gained about 2 hours of mental freedom every day to live my life, with fewer hypos. I've lost almost 10 lbs just from not drinking as much juice. I look forward to adding the glucagon someday, because my BG variability swings from being insulin sensitive to insulin resistant. Thank you, Ed Damiano and BetaBionics!

[@jtspetersen]

I love the clear strategic thinking and very conscious language Ed uses. I agree 100% that the community gets so focused on hyper gaming the time in range with whatever system they are using. I really support the focus on reducing the need for complicated input and focusing on creating a truly user friendly system. Great interview and I look forward to seeing more from Beta Bionics in the future.

[@Papamatarese]

Omg!! Yes!!! Whoooo! I have the I let pump after watching your video on it. The i let works so good for me I can’t wait for that one to come out too🥳🥳🥳 Awesome videos thank you! Keepm going 🍻

[@dawnb2224]

This is an awesome interview. Thanks so much for this. It is very interesting to hear all this, why he started, where he went and the entire process. So educational. Very exciting.

[@dougfabrizio2794]

Great interview Justin! And amazing work by Ed that I greatly appreciate being worked on!! I am someone who likes having "access to the knobs" as he stated, so I'm assuming that the Islet won't be for me even once the dual chamber functionality is available. But with that said, my guess is that the innovations here will allow other companies to tinker around with similar ideas in the future, so it'll probably benefit us all. My dream scenario, at least as far as pumps go, would be something with the profile / support of the OP5 (no tubing), dual chamber, with the algorithms' of Loop.

[@karenmielish-clausell]

Thankyou Justin this is very informational I love your content

[@karentomaziefski6056]

Great interview Justin.

[@matthewcolburn9930]

Thank you for sharing this. I’m curious to see how this develops.

[@reedmclean506]

I love my ilet i would like to tell my story mid west farmer and miner

[@kobybrown6531]

Also I’m wondering if you could find out when Beta will have other infusion sets available that are longer such as a 9mm. The current only offer a 6mm.

[@elizabethedmond6315]

First day on pump .Feeling freedom and very impressed. I am excited. 🎉

[@diabe_tech]

Incredible!!! 🎉

[@jasonnov118]

I wonder if our bodies can get glucagon resistant like with insulin and if the algorithms would need to take that into consideration over time. Cool video, thanks!

[@scottmanies8614]

I would like AI and my Apple Watch (health and movement data) and location (work vs home) to factor into insulin dosing. If I’m busy working active then it would dial my dosing down to prevent the spike and low that happens afterwards. Since it now knows where I’m at GPS it should notice I’m at CFA and the time lunch-dinner. It then could either communicate with the app used to order my meal or know what to ask me to figure out my meal announcement. Most people are creatures of habit and only have 2-3 choices for meals and probably a few more for snacks. The more information I can feed into the delivery device the better it can predict and deliver a desired outcome.

[@brendaparker6766]

Thank you for all the info, granddaughter is 6, hoping for the bi-hormonal pump!

[@clarkkent7973]

Fascinating discussion of glucagon (timestamp: 8:03) . Several new medications in clinical trials have long-acting glucagon that is taken once a week (next generation of Ozempic/Wegovy/Mounjaro/ZepBound medications). This include Eli Lilly's retatrutide, and Boehringer Ingelheim's (Zealand Pharma) survodutide. These are being tested as treatment primarily for obesity. It is not being tested in type-1 diabetics. Of course, long-acting (week long) insulin is being tested in type-1 diabetics.

[@kaptaintrips]

In the middle of 2024, it seems we are on the cusp of a new revolution of pump therapy. Your podcast, A.I. and guys like Mr. islet are leading the charge! I wish I could hop into a DeLorean and jump to 2034 and see how much things have advanced for T1Ds. Thank you for this deep dive, Justin 😊

[@anitastokar98]

Yes. That would be so cool if we could see into the future

[@sarahwolfmoon]

Awesome 😎

[@kobybrown6531]

I would love to be on the pivotal trial for the bi chamber ilet. Please send my info to Beta.

[@gurugamer8632]

Please can you do a video in-depth analysis of Omnipod 5 vs Tandem mobi covering comfort, time in range and better algorithm.

[@rebeccaching5928]

I want this pump. I tend to run high or not correct highs bc my lows are so hard on me. I don't excersize as hard bc of lows. I wear Dexcom, but it sometimes is inaccurate or unavailable during long, warm-ups. I believe in being involved with my diabetes, but at times, it's exhausting

[@mikelcaldwell]

I've been on the iLet for 5 weeks. Unfortunately, it continues to make me use sugar to correct multiple times a day and overnight. I would love to be in the beta test group for the bi-hormonal system. Otherwise, I'll return the pump.

[@anthonyshelley6083]

It really leveled off for me 5 to 6 weeks in. Went from a low every day to every few days.

[@mikelcaldwell]

Anthony, what was the trick? With my educator, I've used "higher" and "lower" settings to no avail. I've eaten more sugar in 5 weeks than I've had in 10 years. T1 for 30 yrs.​@anthonyshelley6083

[@simcott]

The main difference with Ilet algorithm is in it's ability to attentively learn. Many people using it, have said that it takes a few months before it truly understands your body. Those same people have also said that the return for their patience is well worth it. "It's a hard climb, but the view from the top is mind-blowing"

[@hitomihutzell]

I am interested in ilet pump.

[@csf1757]

I'm a non-Phase 1 secretor (and an iLet user, 6 months) .. makes me curious as to the stratus of my alpha cells, and if they are able to secrete glucagon.

[@lthomas63]

I would be interested in it, but I’m wondering is the current pump that they sell upgradable does it have a second cylinder area where you can actually update the software and then use it as a buy hormonal pump or do you have to buy a whole new pump after it’s been approved?

[@dakotahawley]

What if you get a new ilet pump, does the pump have to relearn you again or are there profiles you can upload? What if turns out you dont like the ilet pump for a reason or another but you like how stabile your blood sugar levels have been. I know you dont set your bolus or basal rates, but does it store that type of information or have a way of showing the user what the equivalent value would be?

[@melindaschleicher5050]

My mom has been prescribed an Ilet and we are currently going through the insurance approval process. My mom is 86, has a history of low blood sugars and is hypoglycemic unaware. Lows can get to 19-21 where rescue has to be given by calling 911. Lowest was 9! She got on a Dexcom, but she is stubborn and barely pays attention to it. Medicare doesn't cover glucagon. Two years ago, an injection of glucagon was $1K at the pharmacy. My mother is at a point in her life where she would rather die than spend that much money on a medication. My concern is the costs of the glucagon for the Ilet. Does insurance pay a percentage towards Glucagon for those who are not on Medicare? I am curious about other insurance policies and if they cover the medication.

[@diabe_tech]

That is a super valid question and I really wish I asked it. I’ll work to get that answer the next time I speak with them. I hope some of my other videos will help you and your mother.

[@csf1757]

Glucagon is unreasonably expensive

[@ForceFreeTrainergirl06]

I tried to join the T1 Registry and wsa turned down after wasting ten minutes filling in all their initial blurb. I've emailed and asked why, because they don't tell you.

[@anitastokar98]

Sorry to hear that. I’m curious as to the reason also

[@kimrall7350]

I stay in 70-130 w/131-250 @ 9% and 0% lows! A1c of just under 6 without a pump. Can the Bi-Hormonal system be programmed for similar results? If not, why?

[@simcott]

I have a friend who was on the Ilet bi-hormonal trial. He said the results were mind-blowing, requiring so little attention, that he was able to completely forget that he had diabetes.

[@kimrall7350]

@@simcott Do you know what his A1c was during the trial?

[@wendys_fries]

iLet pump the best