Insulin Pump to Multiple Daily Injection Transition Clinical Trial

Exclusion Criteria

• •1. Age \<18 years and \> 65years
• •2. HbA1c \>8.5 % at screening
• •3. Less than 12 months of insulin treatment
• •4. Patients on 670G or Tandem Control IQ (Medtronic and Tandem Hybrid Closed-loop systems) and not willing use manual mode during the study period
• •5. Patients with T1D using any glucose lowering medications other than insulin
• •6. Pregnancy, breast feeding, and positive pregnancy test during screening
• •7. Women of childbearing age wanting to become pregnant or not using adequate contraceptive measures
• •8. Current or recent (\< 2 weeks prior to visit 1) use of any steroidal medication, or anticipated steroidal treatment, during the study period
• •9. eGFR below 45 ml/min/1.73 m\^2 using MDRD formula
• •10. History of severe hypoglycemia in the previous 3 months
• •11. History of diabetic ketoacidosis (DKA) requiring hospitalization in the past 3 months
• •12. History of allergy to any form of insulin or its excipients
• •13. History of allergy to adhesives
• •14. Unwilling to use blinded CGM during the study period
• •15. Unwilling to perform SMPG at least 4 times a day
• •16. Known history of alcohol abuse or illicit drug use within 6 months prior to screening
• •17. Use of investigational drugs within 5 half-lives prior to screening
• •18. Participation to other study trials during the study period
• •19. Elevated liver enzymes (AST and ALT) 3 times the upper limit of normal
• •20. Hypoglycemia unawareness defined as GOLD score ≥4 \[20\]
• •21. Any comorbidities or medical conditions that make a person unfit for the study at the discretion of the investigators
• •22. Anticipated travel across different time zones (difference greater than 4 hours) or anticipated change in physical activities or diet at the discretion of the investigators.