The Effect of Hedia Diabetes Assistant on TiMe-in-range in People With Type 1 Diabetes and Sub-Optimal Glycemic Control in France - A Randomised Controlled Trial.

The goal of this randomized controlled study is to assess the clinical performance and safety of Hedia Diabetes Assistant in adults with type 1 diabetes and suboptimal glycemic control in France. The main question to answer is:

- Does Hedia Diabetes Assistant improve glycemic control? Researchers will compare Hedia Diabetes Assistant in addition to standard treatment to standard treatment alone to see if Hedia Diabetes Assistant can improve glycemic control.

Subjects will:

* Use Hedia Diabetes Assistant in addition to their standard treatment or only use standard treatment for 6 months.
* Visit the clinic once when they are included into the study and will otherwise be followed remotely.
* Fill out questionnaires when they are included and after 6 months.

This randomized controlled trial will enroll 154 adults with type 1 diabetes who have suboptimal glycemic control and are treated with multiple daily injections (MDI) of insulin using a pen-based basal-bolus regimen. Subjects must be using a continuous glucose monitor (CGM) as part of their standard care and be telemonitored.

The study will be conducted at multiple centres in France, with each subject followed for a total duration of six months. During this period, they will have one in-person visit and two follow-up assessments conducted via phone. Data will be collected through the telemonitoring platform.

Subjects will be randomly assigned to either the intervention or control group. The intervention group will use the Hedia Diabetes Assistant in addition to their standard treatment for six months, while the control group will continue with their standard treatment.

Eligibility Criteria:
Inclusion Criteria:

* Signed informed consent
* Aged ≥ 18 years at the time of signing the informed consent
* Ability to understand, speak and read French fluently
* Diagnosed with type 1 diabetes \> 12 months prior to the day of screening
* Time in range \<60% of last 14 days
* Subject must have the cognitive and physical skills to use mobile applications
* Access to a smartphone with iOS version 13 and up or Android version 8 and up
* Treated with the same pen-based insulin regimen with basal insulin (insulin glargine, degludec, or detemir) and rapid-acting insulin (insulin aspart, lispro, glulisine) for at least the three preceding months
* Real- time CGM use ≥ 3 months from screening date with ≥70% measurements for the last ≥ 14 days
* Willing to use the same CGM for the duration of the clinical investigation
* Being tele monitored ≥ 3 months (including CGM data) by a health care professional and willing to continue during the study period
* If female participants of childbearing potential; willing to have a pregnancy test performed and to use a highly effective method of contraception
* Affiliated to the French social security system

Exclusion Criteria:

* Use of human insulin or premixed insulin
* Using a bolus calculator as a part of standard of care treatment at the time of screening
* If the principal investigator deems that subjects are not healthy, not capable of completing the investigation or in other ways deemed unfit for participation in the investigation
* Ongoing participation in other interventional clinical trials or investigations during the investigation period if the principal investigator deems this to potentially affect the safety, clinical performance and/or any study outcomes
* Female who is pregnant, breast-feeding or intends to be pregnant during the investigation period
* Participant under guardianship, conservatorship, safeguard of justice, or any other legal protection measure for a vulnerable adult