A Hybrid Closed-loop Insulin Delivery System for Blood Sugar Control in Patients with High-risk Acute Lymphoblastic Leukemia Undergoing Chemotherapy

Inclusion Criteria

• Patients ages 10 years old and above
• Patients who are newly diagnosed with high-risk acute lymphoblastic leukemia
• Patients who have started or will start an induction chemotherapy regimen containing steroid and asparaginase
• Patients (if over 18 years of age) or parent/guardian (if the patient is under 18 years of age) must be fluent in reading and speaking English
• Patients must have a parent or guardian living in the home with the participant who also receives training on diabetes, CGM, HCL therapy, and the safety protocols

Exclusion Criteria

• Preexisting diabetes
• Severe psychiatric disease or developmental delays, that might interfere with ability to provide informed consent
• Active skin condition that would affect sensor placement
• Any other medical condition which in the opinion of the investigators impairs the person’s ability to safely participate in the trial, including but not limited to: * Significant kidney disease (estimated glomerular filtration rate [eGFR] < 60) or requiring hemodialysis * Significant liver disease (aspartate aminotransferase [AST] or alanine aminotransferase [ALT] over 20 times the upper limit of the normal) * History of adrenal insufficiency * History of abnormal thyroid stimulating hormone (TSH) consistent with hypothyroidism or hyperthyroidism that is not appropriately treated *History of thyroid cancer
• Use of intravenous or oral acetaminophen more than 60 mg/kg/day (maximum 4000 mg/day)