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By Marzia Khan Reviewed by Danielle Ellis, B.Sc.

Mechanics of insulin pumps: Precision delivery for blood sugar control
Understanding basal rates and bolus doses
Clinical and lifestyle benefits of insulin pump therapy
Key factors in choosing and using an insulin pump
Advances shaping the future of insulin pump technology
References
Further reading

With the prevalence of diabetes quadrupling in recent decades and currently impacting more than 500 million people in the world, it is no surprise that the technology for insulin delivery has also evolved.1,2

An insulin pump is a cell phone-sized wearable device that carries a reservoir of insulin for the user. This device is programmed to dispense specific volumes of insulin automatically when consuming food.3

While the first commercial insulin pump reached the market in the 1970s, its rapid uptake by users only occurred from the early 2000s, with the Diabetes Control and Complication Trial (DCCT) in the early 1990s demonstrating the significance of intensive insulin therapy for optimum glycemic control and avoid complications related to diabetes.4

Since its uptake, insulin pumps have been shown to be an innovative alternative to multiple daily insulin injections for those with diabetes who require insulin to manage their condition.5

Additionally, users of insulin pumps have their basal insulin constantly delivered without worrying about remembering to inject their insulin, with the device having the capacity to be programmed to deliver a higher amount of insulin at particular times during the day or even during sleep.3 Mechanics of insulin pumps: Precision delivery for blood sugar control

There are three main components of insulin pumps: (i) the pump, (ii) the infusion set, and (iii) the sensor and transmitter in sensor-augmented insulin pumps.2 An insulin pump system featuring a continuous glucose sensor to monitor blood sugar levels, an infusion set to deliver insulin, and a pump device for precise diabetes management.

Most devices consist of a pump and infusion set that are separate from each other, with a connecting plastic tube; however, some devices combine both of these components without the requirement of a tube – this is known as a tubeless pump.2

Tubed insulin pumps utilize a long and thin tube that connects the pump to a cannula under the skin to deliver insulin to individuals. A tubed insulin pump is usually constructed with durable plastic and metal, with an interactive screen for viewing and modifying various settings. It also consists of a cartridge or reservoir of insulin with a replaceable or rechargeable battery.5

Most reservoirs require changing every two to three days or once the insulin runs out.2 Most components of the device, such as the reservoirs and tubing, are replaced, but the pump itself usually lasts for many years.5

However, tubeless insulin pumps, such as patch pumps, use a flexible plastic tube or cannula under the skin, with the insulin reservoir and cannula being part of one “pod” that sits on the skin with the aid of an adhesive patch. This category of devices does not utilize an external tube, and the pump is managed using a handheld wireless controller.5

This type of pump consists of the user filling the reservoir with insulin before attaching the pod and fixing the adhesive to the skin. A button is then pushed to release a needle that is threaded through the cannula in the pod, which is retracted back into the pod and remains under the skin.5 Understanding basal rates and bolus doses

Insulin pumps mimic the way the pancreas naturally releases insulin in two different ways.5

The first way is through basal insulin, consisting of small and continuous insulin doses. Most pumps deliver basal rates that the user and their healthcare provider manually program.5 This consists of the insulin being continuously delivered at a preset or auto-adjusted rate for a basal supply, which lasts for 24 hours.2,5

Basal rates require changing over time as the body and routines change, which would need adjustment with the help of a healthcare provider. All pumps can automatically adjust basal doses dependent on an individual’s glucose levels, which are monitored via a connected continuous glucose monitoring (CGM) program.5

Image Credit: News-Medical.net

Another way pumps work is through bolus doses, including manual increases of insulin when eating or to correct high blood sugar. Pumps utilize information entered about carbohydrate intake and blood sugar levels to calculate how much bolus insulin is required. A majority of pumps provide a recommended dose that a user can either confirm or adjust before delivering insulin.2,5,7 Clinical and lifestyle benefits of insulin pump therapy

Insulin pumps deliver continuous insulin with a flexible and precise approach to managing a diabetes diagnosis. There are many benefits of using an insulin pump compared to traditional management methods such as insulin injections.8 Related StoriesResearchers identify key mechanisms behind heart disease in type 2 diabetesFive servings of dark chocolate a week may protect against type 2 diabetesEating breakfast later lowers blood sugar spikes in type 2 diabetes patients

Insulin pumps offer improved glycemic control as the continuous delivery of insulin and precise adjustment enable users to have more stable blood glucose levels.4 Subsequently, this decreases the risk of hyperglycemia, also known as high blood sugar, as well as hypoglycemia or low blood sugar.8

Additionally, insulin pumps can also provide a higher level of flexibility and freedom in lifestyle choices, including meal timing, exercise, and travel, without the thought of having to inject insulin depending on the activity.4,8 However, with the use of injections, any changes to basal insulin require careful planning several hours in advance.6

Insulin pump users can easily adjust and modify insulin delivery for various activities, including spontaneous events, leading to an increased quality of life and a sense of control over their diabetes management.8 The Impact of Glucagon on Diabetes Management

A statistical study reported the most common insulin-related errors, which included missed doses of insulin (25%), timing errors (22.7%), and missed documentation of insulin doses (15.5%).1 With these in mind, the use of an automated insulin delivery system, such as through an insulin pump, may be more beneficial to mitigate the risks of missed doses.8

While an insulin pump can cost approximately $6000 in the United States, with the supplies costing between $3000 to $6000 yearly, patients who switch from multiple-dose insulin injections to pumps in a managed care setting have seen a reduced insulin expenditure by approximately $657 per year.9 Key factors in choosing and using an insulin pump

Many insulin pumps are integrated with continuous glucose monitoring (CGM), which continuously tracks glucose levels in real-time, enabling automated insulin adjustments and alerts and enhancing overall glucose management.8

However, while pumps are advanced devices, there are some drawbacks and considerations, such as the cost of insulin pumps and their supplies, which can be expensive and act as a barrier for many individuals unable to afford these devices.8

Additionally, there is also a need for ongoing education and support required for users of insulin pumps in order to be able to manage the device effectively. This can be a limitation for some who may find the technology to be overwhelming or complicated.8

Potential complications with insulin pumps also include technical issues and malfunctions, as with any electronic device, which requires users to be prepared to troubleshoot these issues and carry backup supplies and insulin.8

Regular pump site care is also required, as the infusion site can occasionally result in irritation, discomfort, or infection.8

Other complications of the pump also include the risk of diabetic ketoacidosis (DKA), as insulin pumps deliver rapid-acting insulin, and so if the pump fails or if there is an obstruction in delivering insulin, this can lead to DKA.8 Advances shaping the future of insulin pump technology

The transformation of glucose management methods has also expanded using artificial intelligence (AI), with this realm introducing innovative strategies. This evolution included transitioning from using pumps based on proportional integral derivative (PID) controllers to using a model based on a predictive control (MPC) approach. MPC utilizes dynamic models to predict future behavior and consider current control inputs.10

Personalized models are also evolving continuously to predict immediate blood glucose events as well as long-term glucose trends through the use of individual blood glucose data, with a high level of accuracy and a margin of error of 10%.10

With advancements in this area of medical devices, newer and more refined technologies aim to have better ease of use and quality of care, which leads to improved glycemic control.2 References Thota S. Insulin. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK560688/#:~:text=The%20insulin%20pump%20is%20a%20device%20that%20works,short-acting%20insulin%20to%20the%20body%20throughout%20the%20day. Published July 10, 2023. Accessed December 2, 2024. Yao PY. Insulin Pump. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK555961/. Published August 28, 2023. Accessed December 2, 2024. Insulin Pump. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/type-1-diabetes/multimedia/insulin-pump/img-20006962. Accessed November 25, 2024. Berget C, Messer LH, Forlenza GP. A clinical overview of insulin pump therapy for the management of diabetes: Past, present, and future of intensive therapy. Diabetes Spectrum. 2019;32(3):194-204. doi:10.2337/ds18-0091. https://pmc.ncbi.nlm.nih.gov/articles/PMC6695255/ Types of Insulin Pumps. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/insulin-pumps. Published November 12, 2023. Accessed November 25, 2024. Singh A. Multiple Insulin Injections Vs Insulin Pumps. Diabetes. https://www.diabetes.co.uk/insulin/mdi-vs-insulin-pumps.html. Published October 29, 2023. Accessed November 25, 2024. Yeh T, Yeung M, Mendelsohn Curanaj FA. Managing patients with insulin pumps and continuous glucose monitors in the hospital: To wear or not to wear. Current Diabetes Reports. 2021;21(2). doi:10.1007/s11892-021-01375-7. https://pubmed.ncbi.nlm.nih.gov/33449214/ Lorenyz C. Insulin Pump Therapy for Glycemic Control: Benefits and Potential Drawbacks. Diabetes Management. 2024;14(4):642-643. doi:10.37532/1758-1907.2024.14(4).642-643. https://www.openaccessjournals.com/articles/insulin-pump-therapy-for-glycemic-control-benefits-and-potential-drawbacks.pdf McAdams B, Rizvi A. An overview of insulin pumps and glucose sensors for the generalist. Journal of Clinical Medicine. 2016;5(1):5. doi:10.3390/jcm5010005. https://pubmed.ncbi.nlm.nih.gov/26742082/ Yu TS, Song S, Yea J, Jang K. Diabetes management in transition: Market insights and technological advancements in CGM and insulin delivery. Advanced Sensor Research. 2024;3(10). doi:10.1002/adsr.202400048. https://onlinelibrary.wiley.com/doi/10.1002/adsr.202400048

 Further ReadingAll Diabetes ContentWhat is Diabetes?COVID-19 and DiabetesWhat Causes Diabetes?Diabetes PathophysiologyMore… 

Last Updated: Dec 11, 2024

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Can the Rangers’ offense be fixed? Five numbers that tell the story of Texas’ lineup woes

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Can the Rangers' offense be fixed? Five numbers that tell the story of Texas' lineup woes

Less than two years ago, the Texas Rangers rode a potent offense to the first World Series championship in franchise history. Since then — on paper, at least — that group has only improved. Established sluggers were brought in. Young, promising players accrued more seasoning. Core stars remained in their primes. And yet, over the course of 10 baseball months since hoisting the trophy on Nov. 1, 2023, the Rangers have fielded one of the sport’s worst offenses, a sobering reality that continues to vex team officials.

The circumstances of 2025 have only intensified the frustration.

The Rangers have received Cy Young-caliber production from a rejuvenated Jacob deGrom, who had compiled fewer than 200 innings over the last four years. Their rotation went into the All-Star break with the second-lowest ERA in the major leagues. Their bullpen, practically rebuilt over one offseason, ranked third. Their defense (16 outs above average) was elite, as was their baserunning (10.8 runs above average). But the Rangers, despite back-to-back wins over the first-place Detroit Tigers this weekend, find themselves only a game over .500, seven games out of first place and 2 1/2 games out of a playoff spot, because they can’t do the one thing they were expected to do best: hit.

Bret Boone, the former All-Star second baseman who was installed as the team’s hitting coach in early May, has been tasked with fixing that — but he is also realistic.

“I’m not gonna come in here and ‘abracadabra,'” he said, waving his right arm as if wielding a magic wand. “That’s the big misnomer about hitting. Hitting is really hard. The bottom line is — you can prepare as much as you want, but when you get in the box, it’s just you and that pitcher.”

Boone isn’t here for an overhaul. He’s here to encourage. To simplify. One of his prevailing messages to players, he said, has been to “watch the game” — to put away the tablet, come up to the dugout railing and see how opposing pitchers are attacking other hitters. Boone has emphasized the importance of approaching each game with a plan, whatever that might be. He has occasionally blocked off the indoor batting cage, worried that hitters of this generation swing too often. And he has encouraged conversation.

“That’s what great offenses do,” Boone said. “They’re constantly interacting.”

There might not be a more interesting team to watch ahead of the trade deadline. Rangers president of baseball operations Chris Young is not one to give up on a season, particularly with a team this talented. But one more rough patch might force him to, at least to an extent. Young would prefer to add, but it’s hard to envision a way to improve the lineup from outside.

He won’t find a better middle-infield combo than Corey Seager and Marcus Semien. Or a better outfield than Evan Carter, Wyatt Langford and Adolis García. Or a better designated hitter than Joc Pederson, who could return from a hand fracture before the end of this month. Or a better catching tandem than Jonah Heim and Kyle Higashioka. Or a better crop of corner infielders than Josh Smith, Josh Jung and Jake Burger, though Burger returned to the injured list with a quad strain earlier this week.

Any offensive improvement will probably come internally, signs of which emerged recently. The Rangers got Carter back from the bereavement list on July 4 and Langford back from the IL on July 5, making their lineup as close to whole as it has been all year. Over the ensuing week, they scored 53 runs in seven games heading into the All-Star break. Maybe it was a sign of things to come. Or, if recent history is any indication, a short burst of false promise.

Below is a look at five numbers that define the Rangers’ surprising offensive downturn.


1. Semien and Seager’s combined OPS on June 22: .671

The Rangers’ rise began in late November 2021, just before the sport shut down in the leadup to an ugly labor fight, when Semien and Seager secured contracts totaling $500 million. Their deals came within days of each other, ensuring they’d share a middle infield for years to come. And when the Rangers won it all in 2023, it was Semien and Seager hitting back-to-back at the top of the lineup, setting the tone for an offense that overwhelmed teams in October.

Some things haven’t changed: Semien and Seager are still the driving forces of this offense. For most of this year, though, that hasn’t been a positive thing.

As late as June 22, with the Rangers 78 games into their season, Semien and Seager had combined for a .229/.312/.359 slash line. Their combined OPS, .671, sat 44 points below the league average.

Semien, traditionally a slow starter, finished the month of May with the second-lowest slugging percentage among qualified hitters and at times batted ninth. Seager made two separate trips to the IL because of the same right hamstring strain and eventually fell out of whack, batting .188 in June. If the Rangers are looking for good news, though, it’s that Semien and Seager finally got going in the leadup to the All-Star break. From June 23 to July 13 — with Seager and Semien settling into the No. 2 and No. 3 spots, respectively — they slashed .313/.418/.592.

“We all want to be on at the same time,” Semien said. “It’ll never happen like that, but if Corey and I are on, this team goes.”


2. Texas’ slash line against fastballs: .236/.312/.372

One of the Rangers’ coaches recently recalled some of the most iconic homers from the team’s championship run — García’s grand slam in the American League Championship Series, and Seager’s blasts against Houston’s Cristian Javier and Arizona’s Paul Sewald.

They all had one thing in common: turning on high fastballs and pulverizing them.

The Rangers were one of the best fastball-hitting teams in 2023. That has been far from the case since. The Rangers slashed just .233/.315/.379 against four-seam fastballs in 2024, worse than every team except the Chicago White Sox, who lost a record 121 games. This year, it isn’t much better.

The Rangers’ slash line against four-seamers was only .236/.312/.372 heading into the All-Star break, good for a .684 OPS that ranked 27th in the majors. Burger (.473 OPS), Heim (.500), Pederson (.620) and García (.660) were especially vulnerable. Against four-seamers that were elevated, no team had a higher swing-and-miss percentage than Texas (55.5%).

Being in position to hit the fastball has been one of the points of emphasis from the hitting coaches in recent weeks. It doesn’t mean every hitter will look fastball first — approaches are individualistic and often alter based on matchups — but it does underscore the importance of narrowing the focus. Opposing pitchers are too good these days. Hitters can’t account for everything. And the best offenses are able to take something away from an opposing pitching staff. The 2023 team took away the fastball as an attack weapon. But the Rangers, in the words of one staffer, have been “stuck in between” ever since — late on velocity and off balance against spin.

It’s a tough way to live.


3. Rangers’ chase rate with RISP: 32.2%

When asked about the biggest difference between the 2023 offense and the 2025 version, Rangers manager Bruce Bochy mentioned the approach in run-scoring opportunities. The team from two years ago, he said, was much better at situational hitting with runners in scoring position. This team seems to chase too much in those situations.

The numbers bear that out.

The Rangers’ chase percentage with runners in scoring position was 32.2% coming out of the All-Star break, fourth worst in the major leagues. Their strikeout percentage, 23.7%, was fifth worst. Their slash line, .230/.304/.357, was down there with some of the worst teams in the sport. The Rangers’ lineup has some strikeout in it — with Burger, Jung and García at the top of that list — but team officials believe it should be much better adept at driving in runs.

Not being able to has led to some dramatic highs and lows. The Rangers have scored eight or more runs 13 times, including two instances over a 72-hour stretch in which they hung 16 runs on the Minnesota Twins. But there have also been 25 games in which they have been held to one or zero runs, third most in the major leagues.


4. Carter’s and Jung’s wOBA ranks since 2023: 205th and 264th

Entering the second half, 380 players had accumulated at least 300 plate appearances since the start of the 2024 season. Among them, Carter ranked 205th with a .308 weighted on-base average. Jung, with a .295 wOBA, ranked 264th.

Jung looked like a budding star at third base in 2023, making the All-Star team and finishing fourth in AL Rookie of the Year voting. Carter came up in September and surged throughout October. With those two and Langford, Texas’ draft pick at No. 4 earlier that summer, the Rangers had three young, controllable players they could surround with their long list of established stars. It seemed unfair, yet it hasn’t come close to panning out.

Carter struggled through the first two months of 2024, was diagnosed with a stress reaction in his back, couldn’t fully ramp back up, got shut down for good in August, didn’t look right the following spring training and started the 2025 season in Triple-A. Carter appeared in just 45 games in 2024. Jung played in only one more, after a wrist fracture held him out for most of the first four months.

Then came a stretch of 101 plate appearances this June during which Jung notched just 15 hits, 5 walks and 27 strikeouts. Eight of those strikeouts came over his last four games, when his chase rate jumped to 45.9% — 12 percentage points above his career average. A Rangers source described him as “defeated” and “lost.”

On the second day of July, Jung was optioned to Triple-A Round Rock.


5. Rangers’ wRC+ since 2023: 94

There might not be a better representation of the Rangers’ drop-off than weighted runs created plus, which attempts to quantify total offensive value by gathering every relevant statistic, assigning each its proper weight and synthesizing it all into one convenient, park- and league-adjusted metric. The league average is 100, with every tick above or below representing a percentage point better or worse than the rest of the sport at that time.

During the 2023 regular season, the Rangers put together 117 wRC+. In other words, their offense was 17% above league average. Only one team — the Atlanta Braves, another currently underperforming club — was better. From the start of the 2024 season to the start of the 2025 All-Star break, the Rangers compiled a 94 wRC+, putting them 6% below the league average. Only eight teams were worse.

Five every-day players from that 2023 team are still on the Rangers — not counting Carter, who didn’t come up until September — and all of them have seen their OPS drop by more than 100 points. Seager? 1.013 OPS in 2023, .856 OPS since. García? .836 in 2023, .681 since. Heim? .755 in 2023, .605 since. Semien? .826 in 2023, .693 since. Jung? .781 in 2023, .676 since.

For Young, it’s not just the individual performances but how they coalesce.

“What we had was just a really balanced approach and a collective mindset in terms of the way we were attacking the opposing pitcher,” Young, in his fifth season as the head of baseball operations, said of the 2023 offense. “We had other guys who could grind out at-bats. We had guys who could hit for average. We had guys who slugged. And I still think we have that in our lineup. It’s just, for whatever reason, a number of them have had bad years to start the season. When you have a couple guys having down years, you can survive. When you have a majority of them having down years, it’s magnified. And then guys start pressing and putting pressure on themselves, and it makes it even harder.”

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If you think electric bikes are bad, there’s a much bigger menace hitting our roads

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If you think electric bikes are bad, there’s a much bigger menace hitting our roads

Electric bikes are a menace. They go almost as fast as a car (if the car is parking), they’re whisper quiet (which makes them impossible to hear over the podcast playing in your headphones), and worst of all, they’re increasingly ridden by teenagers.

By now, we’ve all seen the headlines. Cities are cracking down. Lawmakers are holding emergency hearings. Parents are demanding bans. “Something must be done,” they cry at local city council meetings before driving back home in 5,000 lb SUVs.

And it’s true – some e-bike riders don’t follow the rules. Some ride too fast. Some are inexperienced. These are real problems that deserve real solutions. But if you think electric bikes are the biggest threat on our roads, just wait until you hear about the slightly more common, slightly more deadly vehicle we’ve been quietly tolerating for the last hundred years.

They’re called cars. And unlike e-bikes, they actually kill people. A lot of people. Over 40,000 people die in car crashes in the US every year. Thousands more are permanently injured. Entire neighborhoods are carved up by high-speed traffic. Kids can’t walk to school safely. But don’t worry – someone saw a teenager run a stop sign on an e-bike, so the real crisis must be those darn batteries on two wheels.

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It’s amazing how worked up people get over a few dozen e-bike crashes when many of us step over a sidewalk memorial for a car crash victim on the way to the grocery store. We’ve been so thoroughly conditioned to accept car violence as part of modern life that the idea of regulating them sounds unthinkable. But regulating e-bikes? Now that’s urgent.

To be clear, this isn’t about ignoring the risks that come with new technology. E-bikes are faster than regular bikes. They’re heavier, too. And they require education and enforcement like any other mode of transport capable of injuring someone, be it the rider or a pedestrian bystander. But the scale of the problem is what matters – and the scale here is completely lopsided. Let’s take New York City, for example. It’s got more e-bike usage than anywhere else in the US, and there are still only an average of two pedestrians per year killed by an e-bike accident. That number for cars? Around 100 per year in NYC. It’s not complicated math – cars are 50x more lethal in the city.

And yet, the person on the e-bike is the one getting the stink eye.

We’ve become so numb to the everyday destruction caused by automobiles that it barely registers anymore. Drunk driving? Distracted driving? Speeding through neighborhoods? It’s just background noise. But the moment someone on an e-bike blows through a stop sign at 16 mph, it’s front-page news and a city council emergency.

Here’s an idea: If we want safer streets, how about we start by addressing the machines that weigh two and a half tons and can hit 100 mph, not the ones that top out at 20 or 28 and are powered by a one-horsepower motor the size of an orange.

But we don’t. Because cars are familiar. Cars are “normal.” Cars are how we built our entire country. And so we turn our attention to the easy target – the new kid on the block. The same old playbook: panic, overreact, and legislate the hell out of it.

Sure, an e-bike might startle you on a sidewalk. But a car can climb that sidewalk and end your life. Which one do we really need to be afraid of?

This isn’t a strawman argument, either. Cars are literally used as mass casualty weapons. It happens all the time. It happened last night in Los Angeles when a disgruntled car driver deliberately plowed into a crowd outside a nightclub, injuring over 30 people. And that wasn’t the only car attack yesterday. Another car rammed into pedestrians on a sidewalk in NYC yesterday morning, leaving multiple pedestrians dead. These aren’t exceptions. This is the normal daily news in the US. It’s depressing, but it bears repeating. This is normal. These are everyday occurrences. Twice a day, yesterday.

While we’re busy debating throttle limits and helmet rules for e-bikes, maybe we should also talk about how tens of millions of drivers still routinely speed, blow stop signs, or scroll Instagram at 45 mph in a school zone. Or how car crashes are the number one killer of teenagers in America. Or we can continue to focus on the kid who forgot to put his foot down at a red light while riding an e-bike to school.

This isn’t satire anymore – it’s just sad. It’s a collective willingness to avoid a real, genuine threat to Americans while simultaneously scapegoating what is, by comparison, a non-threat.

The truth is, electric bikes aren’t the menace. They’re a solution. They’re one of the few glimmers of hope in a transportation system drowning in pollution, congestion, and daily tragedy. They make mobility cheaper, cleaner, and more accessible. And yet we treat them like an invasive species because they disrupt the dominance of the automobile.

It’s time to stop pretending we’re protecting the public from some great e-bike emergency. The real emergency is that we’ve accepted cars killing people as a fair trade for getting to Target five minutes faster.

So yes, let’s make e-biking safer. Let’s educate riders, build better bike infrastructure, and enforce traffic rules fairly. Those are all important things. We absolutely SHOULD invest in training programs to educate teens on safe riding. We absolutely SHOULD cite and fine dangerous riders who could threaten the lives of pedestrians. But let’s stop pretending that e-bikes are the problem when they’re clearly a symptom of a much bigger one.

If you’re really worried about the dangers on our streets, don’t look for the kid on the e-bike. Look for the driver behind them, sipping a latte and going 20 over the speed limit.

Now that’s the menace.

Image note: The first and last images in this article were both AI-generated, and represent everyday car/bike interactions

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Experts say ‘just a starting point’ as Crypto Week ends on a high note

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Experts say ‘just a starting point’ as Crypto Week ends on a high note

Experts say ‘just a starting point’ as Crypto Week ends on a high note

The GENIUS Act marks a turning point for crypto regulation, but experts say true integration with finance and identity systems is only beginning.

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