Safety and Effectiveness of Automated Insulin Delivery (AID) Systems in Physically Active Adults With Type 1 Diabetes

Inclusion criteria

• Males and females aged ≥ 18 years old.
• Clinical diagnosis of type 1 diabetes or latent autoimmune diabetes in adults (LADA) for at least one year. (The diagnosis of type 1 diabetes is based on the investigator's judgment; C peptide level and antibody determinations are not needed.)
• Using automated insulin delivery systems (Commercial or DIY) for at least 3 months.
• Willing to share CGM data and insulin pump data with the research team. This access will be limited to the study period.
• Exercising at least twice weekly (Questionnaire assessment MAQ) or willing to exercise at least twice weekly during the study period.
• Willing to share physical activity tracker data with the research team and if applicable, data about the menstrual cycle.

Exclusion criteria

• Do not understand French or English
• Anticipated therapeutic change (including change of insulin type [switching to biosimilar is acceptable] and/or type of CGM sensor) between admission and end of the study.
• Anticipated need to use acetaminophen (dose above 1g every 6 hours) or vitamin C (dose above 500mg DIE) between admission and end of the study.
• Pregnancy (ongoing or current attempt to become pregnant).
• Breastfeeding.
• Uncontrolled thyroid disease (recent less than 5 months TSH should be in target range and treatment stable for at least 6 weeks).
• Severe hypoglycemic episode within two weeks of screening.
• Severe hyperglycemic episodes requiring hospitalization in the last 3 months
• Current use of glucocorticoid medication (except low stable dose and inhaled steroids and stable adrenal insufficiency treatment e.g., Cortef®).
• Current use of adjunct therapy such as SGLT-2 inhibitors or GLP_1 receptor analog unless at a stable dose for at least 3 months, without anticipated change during the study and appropriate ketone testing is performed in case of off-label SGLT2 usage.
• Anticipated radiologic examination incompatible with CGM wear for more than 10 days between admission and end of the study (e.g., repeated MRI).
• Physically inactive participants (see inclusion criteria #5).
• People with professional activities involving night shifts, as it may influence glycemic profiles differently compared to people working days and sleeping nights.
• In the opinion of the investigator, a participant who is unable or unwilling to complete the study (e.g., recent injury, foot wound, etc.).