# Interpretable Language Model for Closed-Loop Type 1 Diabetes Control

arXiv: https://arxiv.org/abs/2607.14126 · HTML: https://mlsanity.com/paper/2607.14126/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 3 of its 19 references that are in the map.
- First posted on arXiv 19 Jun 2026.

## Builds on (most cited first, 3 of 3)

- [LoRA: Low-Rank Adaptation of Large Language Models](https://mlsanity.com/paper/2106.09685/) (2021)
- [Beyond Distillation: Pushing the Limits of Medical LLM Reasoning with Minimalist Rule-Based RL](https://mlsanity.com/paper/2505.17952/) (2025)
- [Deep Reinforcement Learning for Closed-Loop Blood Glucose Control](https://mlsanity.com/paper/2009.09051/) (2020)

## Abstract (arXiv)

Type 1 Diabetes (T1D) is a chronic, life-threatening autoimmune condition characterized by the complete destruction of insulin-producing pancreatic beta cells. While Artificial Pancreas Systems (APS) powered by Reinforcement Learning (RL) have shown promise in automating insulin delivery, their ``black-box'' nature makes it hard for patients and doctors to trust them fully. This paper presents LLM-T1D, a promising approach that combines the precision of RL with the clear, human-like reasoning of Large Language Models (LLMs) to create a more transparent and reliable insulin pump controller. By training an expert RL system and distilling its knowledge into fine-tuned LLaMA 3.1 8B and Qwen3 8B models, we developed a controller that not only surpasses the RL system's performance but also explains its decisions in plain, understandable language. Tested on the FDA-approved UVA/Padova T1D simulator, the LLM controllers deliver excellent blood sugar control (73.5% Time in Range) while maintaining strict formal safety verification against hallucinations.