Grant: Project Grant

Most people living with type 1 diabetes struggle to achieve optimal glucose targets which can lead to devastating complications such as blindness, kidney failure, and heart disease. The automated insulin delivery (AID) systems improve glucose management and quality of life of these individuals. These systems consist of a continuous glucose monitoring device that communicates with an insulin pump, with a software to continuously adjust insulin flow. Also known as artificial pancreas, these systems still require patients to make multiple adjustments: input meal time and contents and announce physical activity. While industry-developed systems are emerging, patients have simultaneously created their own systems. These open-access systems are free, easily accessible (worldwide), allow for pairing different brands of sensors and pumps, and offer extensive customization options. Although these systems are highly popular, they are not regulated by Health Canada. This research will be the first randomized controlled trial to provide head-to-head comparison among different AID systems in adults with type 1 diabetes under free-living conditions, which provides important evidence-based data to guide the choice and optimize use of AID systems. Participants will use two commercial systems and their open-access system, in random order, for eight weeks each. Substudies on the effectiveness of the systems with meal related issues (e.g. various carbohydrate intake) and physical activity will be conducted. This study involves three well-established centers in type 1 diabetes technology research: Stanford University, the University of Alberta, and the Montreal Clinical Research Institute.