Patient description: The patient is a 24-year-old man who has had type 1 diabetes for 11 years. He presents to the emergency room with hyperglycemia and concern for possible diabetic ketoacidosis after not taking his insulin for 3 days. The patient reports that he is currently homeless and has lost his supply of insulin, syringes, glucometer, and glucose testing supplies. The patient states that at the time of his initial diagnosis with type 1 diabetes he was hospitalized with a glucose value >1000 mg/dL. At the time, he was experiencing polyuria, polydipsia, and polyphagia. He reports that he has been on insulin since the time of his diagnosis, and he has never been prescribed oral agents for diabetes management. Most recently, he has been using insulin glargine 55 units once daily, and insulin aspart sliding scale 3 times daily. The patient has had previous episodes of diabetic ketoacidosis, for which he was hospitalized. With this episode of hyperglycemia, he is not experiencing any nausea, vomiting, or abdominal discomfort, and he appears well. His lab studies showed: A1c: 11.3% Creatinine: 0.9 mg/dL with eGFR >60 mL/min Aspartate aminotransferase (AST): 17 U/L Alanine aminotransferase (ALT): 14 U/L Beta-hydroxybutyrate: 0.1 mmol/L Bicarbonate: 25 mEq/L Anion

Clinical trial eligibility criteria: eligible ages (years): 18.0-65.0,  Type 1 Diabetes Type 1 diabetes mellitus (American Diabetes Association definition) HbA1c greater than or equal to 7.5% Intensive insulin treatment for at least 3 months Physical and intellectual ability to operate MIP system Subject has been under the routine care of the investigator for at least two months prior to enrollment Subject has a reliable support person (defined as a person who has daily contact with the subject and knows whom to contact in the event of an emergency) Capability and willingness to perform self-monitoring of blood glucose at least four times daily for 9 months of the study and 7 times daily for 3 months of the study Physical and intellectual ability to operate the MIP system and to comply with the data reporting requirements of the study Subject is willing to sign the informed consent form (approved by local Institutional Review Board and Medtronic MiniMed)  The subject's insulin usage exceeds 66 units per day Severe complications such as advanced autonomic neuropathy, legal blindness, or symptomatic cardiovascular disease as evidenced by a cardiovascular episode within the last six months Reside at or plan to travel to elevations above 8000 feet during the study period (commercial airline travel is acceptable) Subject who is pregnant, of childbearing potential or lactating and is neither surgically sterile, using contraceptives (devices, oral or implanted) nor other physician approved contraceptive The subject has any major concomitant disease or any physical or psychological disorder within the last five years, which might be considered life threatening, or which might confound the collection or interpretation of the study data The subject has previously enrolled in or participated in an investigational drug or device study within the preceding 4 weeks The subject has any condition that precludes him/her from completing the study requirements Has plans for activities which require them to go 25 feet below sea level