Closed Loop and Education for Hypoglycemia Awareness Restoration

This study tests whether using a closed-loop insulin delivery system (also called an "artificial pancreas") combined with special education can help people with type 1 diabetes who no longer feel the warning signs of low blood sugar (a condition called impaired awareness of hypoglycemia, or IAH). When you stop feeling low blood sugars coming on, it becomes dangerous — this trial aims to restore that awareness. **You may be eligible if...** - You have type 1 diabetes - You score 4 or higher on a standard hypoglycemia awareness questionnaire (Gold or Clarke score) - You have had type 1 diabetes for 10 or more years - Your HbA1c is below 10.5% - You can read and speak English - Your daily insulin dose is less than 1 unit per kilogram of body weight **You may NOT be eligible if...** - You have a medical condition that limits your ability to participate (e.g., cognitive issues, active cancer, organ failure) - You have active problems with alcohol or drug misuse - You have significant social challenges (homelessness, food insecurity) - You have a seizure disorder unrelated to low blood sugar - You have a skin condition that prevents wearing a continuous glucose monitor (CGM) - You have recently used high-dose steroids - You have significantly reduced kidney function Talk to your doctor to see if this trial is right for you.