Closed-loop Glucose Control for Automated Management of Type 1 Diabetes

Inclusion Criteria (type 1 diabetic subjects): * Age 18 years or older * Clinical type 1 diabetes for at least five years * Otherwise healthy (mild chronic disease allowed if well controlled) * Diabetes managed using an insulin infusion pump * Body mass index (BMI) between 20 and 31 * Total daily dose (TDD) of insulin ≤ 1 U/kg and ≤ 100 U/day * Post-prandial C-peptide \< 0.1 nmol/L at 90 minutes in a mixed meal (Sustacal) tolerance test by the DCCT method * Hemoglobin A1c less than or equal to 8.5% * Prescription medication regimen stable for at least 1 month Inclusion Criteria (non-diabetic subjects): * Age 18 years or older * No personal history of diabetes, impaired fasting glucose, or impaired glucose tolerance * No personal history of pancreatic disease * Not taking medication that may affect glucose, insulin, or glucagon dynamics * Otherwise healthy (mild chronic disease allowed if well controlled) * Body mass index (BMI) between 20 and 31 * Normal 75 g oral glucose tolerance test (fasting, 1 hour, and 2 hour measurements) Exclusion Criteria (all subjects): * Unable to provide informed consent or are unable to comply with study procedures * Current participation in another clinical trial * Anemia (HCT or hemoglobin less than normal for sex) * Elevated alanine aminotransferase (ALT \> 3 fold above upper limit of normal) * Untreated or inadequately treated hyperthyroidism or hypothyroidism (abnormal TSH or free T4) * Pregnancy (positive urine HCG), breast feeding, plan to become pregnant in the immediate future, or sexually active without use of contraception * Progressive or proliferative diabetic retinopathy (subjects with mild, non-proliferative background retinopathy or stable disease previously treated with photocoagulation are not excluded). * Renal insufficiency (creatinine clearance estimated by Cockcroft-Gault equation of ≤ 50 ml/min) * Any known history or symptoms of coronary artery disease. * Abnormal EKG * Congestive heart failure * History of TIA or stroke within preceding 6 months * Acute illness or exacerbation of chronic illness at the time of the study procedure * Change in medication regimen in the 30 days prior to enrollment * History of seizures * History of pheochromocytoma * Abnormal plasma fractionated metanephrines * History of adrenal disease or tumor * History of pancreatic tumor, including insulinoma * History of impaired gastric motility or gastroparesis requiring pharmacological or surgical treatment * Current alcohol abuse (\> 3 drinks daily) or substance abuse (any use within the last 6 months of illegal drugs) * Severe mental illness (schizophrenia, bipolar disease, inadequately treated depression, or any psychiatric hospitalization in the last year) * Impaired cognition or altered mental status. * Hypertension (blood pressure \> 140/90) at the time of screening * Use of medications that reduce gastric motility * Electrically powered implants that might be susceptible to RF interference * Use non-insulin injectable anti-diabetic medications, inhaled insulin, or oral anti-diabetic medications * History of adverse reaction to glucagon (including allergy) besides nausea and vomiting. * Established history of latex, adhesive, tape allergy, inadequate venous access, history of allergy to or intolerance of aspirin.