Cohort Study to Refine the Positioning of Closed-loop Therapy Versus Islet Transplantation in the Management of Patients With Unstable Type 1 Diabetes

This study is comparing two advanced treatment options for people with unstable type 1 diabetes who experience dangerous, unpredictable blood sugar swings despite using the best available technology: closed-loop insulin delivery (an automated "artificial pancreas" system) versus islet cell transplantation (transplanting insulin-producing cells from a donor pancreas). **You may be eligible if...** - You have type 1 diabetes with severe and persistent blood sugar instability for more than 12 months - You have had at least 2 severe hypoglycemic episodes requiring help from another person in the past year, OR at least 1 life-threatening episode (coma, seizure, or serious injury) - You have been monitored by a specialist diabetes team using insulin pump and continuous glucose sensor technology **You may NOT be eligible if...** - You do not meet the criteria for islet transplantation - Your blood sugar instability is not severe enough to qualify Talk to your doctor to see if this trial is right for you.