Accordingly, the iLetTM system was designed to reduce diabetes burden and thus only allows users to indicate meal type and relative size (“usual,” “more,” or “less”) but not specific carbohydrate amounts, and decreased HbA1c from 7.9% to 7.3% and improved TIR from 51% to 65% in 219 youth and adults relative to injections, non-automated insulin pumps and hybrid closed-loop (43, 44). Here, INS is linked to diabetes mellitus.