To Study the Efficacy and Safety of Medtronic 780G Insulin Pump in People With Gastroparesis and Type 1 Diabetes.

Inclusion criteria - Age ≥18 years - Diagnosis of T1D for at least 12 months with stable insulin regimen for at least 2 months - HbA1c ≥8.0% - Diagnosis of gastroparesis per National Institute of Health (NIH) definition - Willing to use Medtronic 780G system either with Simplera CGM. - Ability to provide willing to sign a consent form before any trial-related activities - If randomized to usual care group and on an insulin pump already, should be willing to use pump in manual mode only for the duration of the study Exclusion criteria - Age \<18 years - Current use of inhaled insulin (Afrezza) - Patients with T1D using any glucose lowering medications other than insulin at the time of screening - Pregnancy, breast feeding, or wanting to become pregnant - Current use (≥ 2 weeks of continuous use) of any steroidal medication, or anticipated long-term steroidal treatment (\>4 weeks continuously), during the study period - History of gastric outlet obstruction or other gastrointestinal structural abnormalities - Estimated glomerular filtration rate (eGFR) \<30 or on dialysis - History of SH in the previous 3 months - History of two or more episodes DKA requiring hospitalization in the past 12 months - Any medical (such as severe cardiovascular disease, malignancy, chronic liver disease) or psychosocial conditions that make a person unfit for the study at the discretion of investigators - Use of investigational drugs within 5 half-lives prior to screening - Current use of cannabis or history of cannabinoid hyperemesis syndrome Always talk to your doctor about whether this trial is right for you.