Type 1 diabetes is a chronic autoimmune condition in which insulin-producing pancreatic β-cells are destroyed. Approximately 1.6 million Americans are affected by type 1 diabetes (1) and must maintain lifelong insulin therapy for survival.

Although insulin is a necessity for the management of type 1 diabetes, its use is not without difficulties and adverse effects for a subset of patients with so-called brittle type 1 diabetes. Brittle type 1 diabetes is the term used to describe very difficult to control diabetes that results in severe hyperglycemia and hypoglycemic unawareness despite the use of intensive insulin therapy and diabetes education (2). Hypoglycemia unawareness, the inability to recognize symptoms of low blood glucose, is a hallmark sign of brittle type 1 diabetes. This specific subtype of the disease affects <80,000 individuals in the United States; however, those who are affected suffer from debilitating symptoms and are at increased...

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