Study to Assess the Metabolic Impact of IRTA© and Patients Satisfaction in Type 1 Diabetic Patients, Treated by Either Insulin Pump or Multiple Daily Insulin Injections, and Using Freestyle Libre®, a Real-time Continuous Glucose Monitoring (IRTA)

Study to Assess the Metabolic Impact of IRTA© and Patients Satisfaction in Type 1 Diabetic Patients, Treated by Either Insulin Pump or Multiple Daily Insulin Injections, and Using Freestyle Libre®, a Real-time Continuous Glucose Monitoring

Clinical Evaluation of Insulin Real-Time Advisor (IRTA©): a Decision Support Software for Insulin Therapy Combined With Freestyle Libre®, a Continuous Glucose Monitoring System: Glycemic Impact and Satisfaction in Type 1 Diabetic Patients

A prospective monocentric " before and after " study, ruled in 2 periods of 3 months : during the first period, the patient will adjust insulin treatment as usual, during the second period, the patient will adjust insulin treatment with IRTA support

Freestyle Libre® continuous glucose monitoring (CGM) system may improve glycemic control. However, this system contributes to the complexity of insulin adjustment by the diversity of the data delivered by CGM system. Insulin Real-Time Advisor (IRTA©), a decision support software, has been developed in order to guide patients in the adaptation of their treatment according to CGM data. IRTA© provides advice applicable to thousand situations according to six parameters: glucose level, trend arrows, meals, physical activity, before bedtime, time since the previous bolus. Type of advice : Insulin injection (carb and correction) To continue treatment without modification To lower the insulin dose (temporary basal rate) Sugar intake advice Glucose level control with CGM, self-monitor blood glucose, blood ketones monitor To change catheter for patients treated by insulin pump.

Percentage of time spent in 70-180mg/dl (time in range) in the last month of each period of the study (without and then with IRTA©)

Assessment of the metabolic impact of IRTA© on "time in range" (time spent in the standard glucose range between 70-180mg/dl, ie 3.9-10mmol/l) in type 1 diabetic patients, treated by either insulin pump or multiple daily insulin injections, and using Freestyle Libre®.

Number of incidents (severe hypoglycemia, diabetic ketoacidosis, hospitalizations related to poor glycemic control)

CGM Satisfaction (CGM-SAT) 44-item questionnaire. Higher scores reflect more favorable impact of, and satisfaction with, CGM use.

Satisfaction questionnaire: 5-point Likert scale (1 = strongly agree; 5 = strongly disagree) with each of 18 items.

Inclusion Criteria: Men and women ≥ 18 years of age Patients with type 1 diabetes mellitus for more than 2 years Treated by either insulin pump for more than 6 months or multiple daily insulin injections. Using Freestyle Libre® for more than 3 months Accepting IRTA use Patient able to provide free and informed consent Patient able to provide written non-disclosure agreement Exclusion Criteria: Pregnancy, breastfeeding or pregnancy project in the future 6 months Patients with no smart phone or internet access Patients legally protected (under judicial protection, guardianship or supervision) Patients with acute illness (psychiatric, infection, cancer,…) Patients using another CGM system (Enlite® or Dexcom G4®)