Glycemic Control and Osteohealth in Adults Living With Type 1 Diabetes

This study is looking at how poor blood sugar control affects bone health in adults with type 1 diabetes. Participants will be starting an automated insulin delivery system (an "artificial pancreas" device) to improve their blood sugar control, and researchers will track whether bone strength and structure improve as a result. **You may be eligible if...** - You are 18 years or older - You have been diagnosed with type 1 diabetes or latent autoimmune diabetes in adults (LADA) for at least one year - Your blood sugar control is currently poor (HbA1c above 8%) with high variability - You are about to start using an automated insulin delivery device - You plan to use this device for the study duration **You may NOT be eligible if...** - You already have well-controlled blood sugar - You are not planning to start an automated insulin delivery device - You have conditions unrelated to diabetes that significantly affect bone health Talk to your doctor to see if this trial is right for you.