Grant: CIHR Fellowship

Over 300,000 Canadians live with type 1 diabetes (T1D), an autoimmune disease destroying vital insulin-producing cells. Insulin is necessary for survival and to regulate blood sugar levels. People with T1D must take insulin lifelong. Despite the advances in diabetes care, only 30% of people with T1D can achieve optimal blood sugar levels which reduces the risk of devastating diabetic complications, such as blindness and kidney failure. Over 80% of people with T1D face weekly low blood sugar with subsequent unease and possible coma. 100 years after the first use of insulin, automated insulin delivery (AID) is an advanced technology that can automatically regulate blood sugar levels in people with T1D. AID systems are pocket-sized, wearable medical devices designed to autonomously track blood sugar and deliver insulin. This game-changing technology has made treatment more efficient (less high blood sugar), safer (less low blood sugar) and simpler (automation). Our first study will compare two types of available AIDs: commercial AID products and freely-available do-it-yourself AID (DIYAID) that can be built by people with T1D at home. DIYAID is more accessible, flexible and less expensive, yet it has not been rigorously tested in clinical trials. Our study will be the first to provide essential evidence on DIYAID's effectiveness, safety and impact on quality of life. This evidence is needed by people with T1D, healthcare professionals and Health Canada. Our second study aims to assess the impact of eating a low-sugar diet while using AID. Even with AID, it is difficult to prevent blood sugar levels from rising after a meal. Eating less sugar is one approach, but we do not know whether combining AID and a low-sugar diet could improve blood sugar safely. Our study will help healthcare professionals and people with T1D to maximize the benefits of AID. Overall, our studies will guide choices for a specific AID (DIYAID) and a specific diet (low-sugar diet).