Inclusion Criteria:  Patients ages 10 years old and above Patients who are newly diagnosed with high-risk acute lymphoblastic leukemia Patients who have started or will start an induction chemotherapy regimen containing steroid and asparaginase Patients (if over 18 years of age) or parent/guardian (if the patient is under 18 years of age) must be fluent in reading and speaking English Parent or guardian living in the home with the participant who also receives training on diabetes, CGM, HCL therapy, and the safety protocols  Exclusion Criteria:  Preexisting diabetes Severe psychiatric disease or developmental delays, that might interfere with ability to provide informed consent Active skin condition that would affect sensor placement  Any other medical condition which in the opinion of the investigators impairs the person's ability to safely participate in the trial, including but limited to:  Significant chronic kidney disease (eGFR <60) or requiring hemodialysis Significant liver disease History of adrenal insufficiency History of abnormal TSH consistent with hypothyroidism or hyperthyroidism that is not appropriately treated History of thyroid cancer Use of intravenous or oral acetaminophen more than 60 mg/kg/day (maximum 4000 mg/day)