Prospective Evaluation of a Dose Guidance System for People With Diabetes Initiating Basal Insulin or Using Insulin Injections

Inclusion Criteria:

• Documented T1D or T2D, for at least 6 months

• Aged ≥ 6 years ≤ 75 years

• HbA1c ≤ 11%

• For Segment 1: Using basal-bolus MDI therapy, i.e. basal insulin and a bolus that iseither:

1. Carbohydrate counting with carbohydrate ratio (CR) and correction factor (CF)

2. Fix dose for meal / meal estimation with CF

• For Segment 2: Using or prescribed basal insulin

• Participants using the following type of insulin as directed in the instructions foruse:

1. Basal insulin: Glargine (including Rezvoglar, Semglee, Toujeo, Soliqua),Degludec (including Tresiba U-100, Tresiba U-200, Xultophy), Determir

2. Bolus insulin: regular insulin, rapid analogues (Insulin Aspart, InsulinGlulisine, Insulin Lispro) or ultra-rapid analogues (Fiasp, Lyumjev)

• Participants willing to use FreesStyle Libre CGM according to manufacturerinstructions, document insulin delivery, meals, and daily activities.

• Participants have a smartphone compatible with study requirements.

• Participants are willing and able to sign a written informed consent form to usetheir data.

• Participants are willing to use the bolus calculator for insulin dosing (only forsegment 1)

Exclusion Criteria:

1. Concomitant diseases/treatment that influence metabolic control or any significantdiseases/conditions including psychiatric disorders and substance abuse or drug oralcohol abuse that in the opinion of the investigator is likely to affect thesubject's ability to complete the study or compromise patients' safety.

2. Relevant severe organ disorders (diabetic nephropathy, diabetic retinopathy,diabetic foot syndrome) or any secondary disease or complication of diabetesmellitus, such as:

3. Subject has unstable or rapidly progressive renal disease or has eGFR < 45 oris receiving dialysis

4. Subject has active proliferative retinopathy

5. Active gastroparesis

6. Participation in any other interventional study

7. Female participant who is pregnant or planning to become pregnant within the plannedstudy duration

8. Individuals who are using one of the following types of insulin:

9. Intermediate-acting insulin (NPH)

10. Mixed insulin like: i. Premix NPH/ Regular (e.g. Humalin 70/30, Novolog 70/30) ii. Premix analogs (e.g,Novolog mix 70/30, Hu,alog mix 75, 25, Humalog Mix 50/50) c. Inhale insulin (e.g.Afrezza)

11. Hypoglycemia unawareness

12. Individuals who are treated with intravenous (IV) insulin injections, or acombination of insulin injections and/or IV insulin and insulin pump therapy.

13. Individuals who have extensive skin changes/diseases at the proposed applicationsites that could interfere with device placement or the accuracy of interstitialglucose measurements.

14. An episode of diabetic keto-acidosis within the month prior to study entry and/orsevere hypoglycemia resulting in seizure or loss of consciousness in the month priorto enrolment.