Integration of Continuous Glucose Monitoring Into a BiHormonal Closed-Loop Artificial Pancreas

Inclusion Criteria: * Age 12 years or older with clinical type 1 diabetes for at least one year * Weight \> 41 kg * Otherwise healthy (mild chronic disease allowed if well controlled) * Diabetes managed using an insulin infusion pump and rapid- or very-rapid-acting insulins * Body mass index (BMI) between 20 and 35 for subjects \>18 years of age or BMI between the 5th and 95th percentile for age for subjects \< 18 years of age * Total daily dose (TDD) of insulin that is \< 1 U/kg * Stimulated C-peptide \< 0.1 nmol/L at 90 minutes after liquid mixed meal by DCCT protocol * Hemoglobin A1c \<= 9% * Prescription medication regimen stable for 1 month Exclusion Criteria: * Unable to provide informed consent for subjects \> 18 years of age or unable to provide assent if \< 18 years of age * Unable to comply with study procedures * Current participation in another diabetes-related clinical trial other than one that is primarily observational in nature. Potential subjects enrolled in trials of passive monitoring equipment are not excluded. * Anemia (HCT less than normal for age and sex) * Alanine aminotransferase \> 3 fold above upper limit of normal * Untreated or inadequately treated hyperthyroidism or hypothyroidism * Pregnancy * Renal insufficiency (creatinine clearance ≤ 50 ml/min) * Any known history of coronary artery disease * Abnormal EKG including, but not limited to evidence of active ischemia, prior myocardial infarction, proximal LAD critical stenosis (Wellen's sign), arrhythmia, tachycardia, and prolonged QT interval (\> 440 ms) * Congestive heart failure * History of TIA or stroke * Acute illness or exacerbation of chronic illness * History of seizures * History of pheochromocytoma (fractionated metanephrines will be tested in patients with history suggestive of pheochromocytoma) * 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 (intake averaging \> 3 drinks daily in last 30 days) or substance abuse (any use within the last 6 months of controlled substances without a prescription) * Untreated or inadequately treated mental illness (indicators would include symptoms such as psychosis, hallucinations, mania, and any psychiatric hospitalization in the last year) * Impaired cognition or altered mental status. * Hypertension (blood pressure \> 140/90 or \> 95% for age, height and weight in subjects \< 18 years of age) at the time of screening * Use of medications that reduce gastric motility (e.g. narcotics, anti-spasmodics, anticholinergics). * Electrically powered implants (e.g. cochlear implants, neurostimulators) that might be susceptible to RF interference * Use non-insulin, injectable anti-diabetic medications * History of adverse reaction to glucagon (including allergy) besides nausea and vomiting. * Established history of latex, adhesive, or tape allergy * Inadequate venous access * History of allergy to aspirin or any history of aspirin intolerance, including Reye syndrome, or gastric ulcer or bleeding associated with salicylates * Blood dyscrasia or bleeding diathesis, such as hemophilia, Von Willebrands disorder, and idiopathic thrombocytopenic purpura (ITP) * Peptic ulcer * Unable to perform 30 minutes of moderate exercise on a treadmill or exercise bicycle * Unable or unwilling to discontinue dietary supplements for at least 2 weeks prior to each CRC admission * History of celiac disease