Could a High-Tech insulin system and Low-Carb diet fix a dangerous diabetes problem?

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Participants with Type 1 diabetes with C-peptide levels less than 200pmol/L. * Type 1 diabetes for 5 years or more. * HbA1c greater than or equal to 53 mol/mol. * Normal renal function. * Normal thyroid function. * Gold Score 4-7 (indicating impaired awareness of hypoglycaemia) * Willingness to monitor blood ketones daily. * Use of freestyle libre device is permitted at study entry and may be continued in participants in group 1 Exclusion Criteria: * Current use of a non-approved closed loop / AID system or those on a predictive low glucose suspend insulin pump. * Proliferative retinopathy * Regular use of real time CGM in the preceding 3 months. * History of Diabetic ketoacidosis in the preceding 6 months. * Severe hypoglycaemic episode requiring external assistance in the preceding 6 months. * Inability to safely use technology used in this study (e.g. impaired vision, memory or dexterity that prevents safe operation of CGM or insulin pump.) * Inability to support the technology requirements for the study (e.g. unable to upload study device at home) * History of Haemophilia, Cystic Fibrosis, pancreatic disease or complete pancreatectomy, ischaemic heart disease, epilepsy or hypoglycaemia induced seizure * History of severe reaction or allergy to adhesive necessary to this study. * Unable to adhere to study timetable. * Unable to give informed consent. * Pregnancy. We will perform a pregnancy test on all eligible participants at baseline. * Concurrent use of any non-insulin glucose-lowering agent (including GLP-1 agonists, Symlin, DPP-4 inhibitors, SGLT-2 inhibitors, sulfonylureas. These may lower insulin requirements and predispose to diabetic ketoacidosis. * Concurrent use of medication that may affect blood glucose such as SSRIs * A condition, which in the opinion of the investigator, would put the patient or study at risk * HbA1c greater than or equal to 75 mmol/mol