Closed loop insulin delivery and glucose control for type 1 diabetes, seven days and nights, hospital to home.

INTERVENTION: Closed loop insulin therapy (or artificial pancreas), compromising of a Medtronic Paradigm Veo insulin pump with continuous glucose sensor, an Android‐based smartphone with the closed loop algorithm software, and a translator that translates messages between the phone and insulin pump. An insulin pump is an external device, which is already used by thousands of patients in the community. There is a small cannula placed subcutaneously through which the insulin is infused ‐ and is attached to the insulin pump by plastic tubing. No anaesthetic is required. The infusion site lasts three days, before needing to be changed to a new site. The continous glucose sensor is a small plastic cannula inserted into the subcutaneous tissue ‐ which then connects to an external transmitting device which communicates to the insulin pump via radiofrequency. A glucose sensor lasts a maximum of 6 days, and does not require an anaesthetic for insertion. Participants will spend this first 48 ‐ 72 hours in hospital learning how to use the technology, before going home and completing a full 7 days. While at home patient will upload their insulin pump daily, and we will use remote monitoring of the smartphone for constant monitoring and checking of adherance. There will be a washout of at least 7 days between treatments. CONDITION: type 1 diabetes PRIMARY OUTCOME: hypoglycaemic events (sensor blood glucose <3.3mmol/L) time spent with sensor blood glucose between 3.9 – 10mmol/L SECONDARY OUTCOME: nil INCLUSION CRITERIA: Age 12‐50 years with type 1 diabetes Duration of diabetes at least 12 months On insulin pump therapy for at least 6 months Carbohydrate counting Using bolus calculator function HbA1C<9%