Effect of Inhaled Technosphere Insulin vs RAA Insulin on Exercise-Induced Hypoglycemia in Adults With T1D Using Automated Insulin Delivery

This study compares two types of insulin for covering meals during exercise in adults with type 1 diabetes who use an automated insulin delivery system (closed-loop pump). It compares inhaled Technosphere insulin (a rapid-acting inhaled insulin) with the standard rapid-acting injected insulin used just before exercise, to see which better prevents blood sugar from dropping too low during physical activity. **You may be eligible if:** - You are between 18 and 65 years old with type 1 diabetes - You use a Tandem t:slim X2 or Tandem Mobi pump with Control-IQ technology for at least 90 days - You use insulin aspart or lispro in your pump - Your total daily insulin dose is between 20 and 80 units - You exercise moderately to vigorously at least 3 times per week for 30+ minutes **You may NOT be eligible if:** - You use a different type of insulin pump or insulin - You do not exercise regularly - You have certain heart conditions detected on ECG - You have conditions that make inhaled insulin unsafe (e.g., lung disease) - You are pregnant or planning to become pregnant Talk to your doctor to see if this trial is right for you.