Grant: Op. Gr.: SPOR & JDRF - ICT MYG - Metab. Control & Art. Pancreas and Devices

Type 1 diabetes requires that patients inject themselves insulin to control the level of sugar in their blood because their pancreas cannot do it anymore. A consequence of this treatment is low blood sugar episodes. This is named hypoglycemia. Severe hypoglycemia has the potential to cause accidents, injuries, coma, and death. Patients voiced a need for better strategies to reduce those episodes. This is the focus of the BETTER program. In this program, we will test an online educational strategy to help patients who are wearing an insulin pump or are wearing a monitor to know in real time their blood sugar, to optimise their use of these devices. It will also include a peer-to-peer forum discussion to further offer social support. The program will be built in partnership with patients. It will be tested across the province of Quebec among adolescents and adults. We hypothesize that this program will help patients reduce hypoglycemia episodes. To recruit patients for this trial, we will first build a registry of patients. From this registry, we will know who is using the devices and who is having the most hypoglycemic episodes. Patients will answer questionnaires annually part of the registry. In this questionnaire they will have to report hypoglycemia, answer to questions on fear of hypoglycemia, if they feel their hypoglycemia, etc. We will also carry out small trials to improve effectiveness of the wearable device measuring blood glucose in real time, to test new strategies to correct a low blood sugar episode, to obtain the point of view of caregivers for helping during serious episodes and finally, to test an artificial pancreas system in a specific condition in which it may be harder for the system to prevent or correct a low blood sugar episode. All these trials will increase our knowledge on hypoglycemia, how to prevent and treat those episodes.