Benefits of hormone replacement therapy (HRT)

Estrogen is a key hormone for women and people with uteruses’ health. Every single part of a their body depends on estrogen to operate at its best—including the brain, bones, heart, and muscles. Just as we have a gut microbiome, we have a vaginal microbiome. Lack of oestrogen means the lactobacilli and other good bacteria in the vaginal microbiome can be replaced by pathogenic ones. Oestrogen also helps collagen production, and collagen disappears from the vulva by up to 30% in the five years after menopause. ³

Randomized studies show that women who initiate HRT within 10 years of the onset of menopause (generally before age 60) have a reduction in all-cause mortality and fractures. Women and people with uteruses may also reduce their risk of cardiovascular diseases by as much as 50%, Alzheimer’s disease by 35%, and bone fractures by 50 to 60%. FDA-approved HRT containing estrogen and progesterone (or estrogen alone as indicated for postmenopausal women without a uterus) can restore declining hormones, and relieve symptoms such as hot flashes, night sweats, sleep disturbances, and bone loss.² It’s safe for most breast cancer patients, too, it’s a win-win on the sex front and you can take it alongside normal HRT. ³

There are currently 7 FDA-approved vaginal estrogen products for the treatment of GSM: creams (Estrace® estradiol, Allergan, Madison, NJ; Premarin® conjugated estrogens, Pfizer, New York, NY; generic estradiol cream 0.01%), tablets (Vagifem® estradiol, Novo Nordisk Inc., Plainsboro, NJ; Yuvafem® generic estradiol, Amneal Pharmaceuticals, Bridgewater, NJ), inserts (Imvexxy® estradiol capsule, TherapeuticsMD, Inc., Boca Raton, FL), and a ring (Estring®, Pfizer). Shared decision making with the patient for choice of vaginal estrogen product is important and can improve compliance with therapy. ¹

But How Is iLet Different?

The most significant difference with the iLet is that there are NO traditional pump settings.  The only initial settings used are the individual’s weight and target range. Because there are no traditional settings, there is no user input for corrections or carb counting.  

Three different algorithms drive insulin delivery. Let’s look at each algorithm²:

Basal Algorithm

• The original basal profile is developed based on the individual’s weight; however, over time, the system continually adapts the basal profile using continuous glucose monitor (CGM) data. 

Corrections Algorithm

• Based on CGM data, the algorithm adds additional insulin beyond the basal requirements every 5 minutes, aiming to maintain blood glucose within the predetermined target rang.

Meal Announcement Algorithm

• When the individual announces a meal, the system customizes the insulin delivery based on dosing history for similar-sized meals.  
• It determines and adapts meal types separately (breakfast, lunch, or dinner).  Initially, the meal dose is calculated, just like the basal rate, and then postprandial corrections are applied if necessary.  Based on this data, the system will continuously adapt to individualize the insulin needs based on the size of meals.
• The only decisions made at meal announcements are:
  • Choosing the meal: breakfast, lunch, or dinner
  • Choosing the size of the meal: If the meal is the usual amount of carbs, smaller, or larger
•  

The only adjustable setting is the glucose target range. There are three different glucose targets to choose from. Two different blood glucose targets can be set within a 24-hour period.³

• 🩸Higher (130 mg/dL)
• 🩸Usual (120 mg/dL)
• 🩸Lower (110 mg/dL)