Type 1 Diabetes Clinical Trial
— SMASHOfficial title:
Simplified Meal Approach Study Using Hybrid Closed-loop Insulin Delivery in Youth and Young Adults With Type 1 Diabetes - a Randomised Controlled Two-centre Crossover Trial
Verified date | October 2023 |
Source | Insel Gruppe AG, University Hospital Bern |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
The purpose of the study is to examine whether a simplified meal approach (as compared to exact carbohydrate counting) can alleviate the need of carbohydrate counting without worsening postprandial control in youth and young adults with type 1 diabetes using hybrid closed-loop insulin delivery with the Cambridge Artificial Pancreas FX System (CamAPS FX system).
Status | Completed |
Enrollment | 46 |
Est. completion date | September 29, 2023 |
Est. primary completion date | September 29, 2023 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 12 Years to 20 Years |
Eligibility | Inclusion Criteria: - Written informed consent - Type 1 diabetes as defined by the World Health Organization for at least 6 months - Age between 12 and 20 years (inclusive) - Proficient use of continuous glucose monitoring (CGM) or flash glucose monitoring (FGM) for at least 5 days in the past - Glycated hemoglobin A1c (HbA1c) =12% - The participant is willing to wear closed-loop devices - The participant is willing to follow study specific instructions - Negative urine-pregnancy test in sexually active female participants of childbearing potential at screening-visit Exclusion Criteria: - Any physical or psychological disease or condition likely to interfere with the normal conduct of the study and interpretation of the study results - Known or suspected allergy against insulin - Participant is pregnant or breast feeding or planning pregnancy within next 6.5 months - Severe visual impairment - Severe hearing impairment - Lack of reliable telephone facility for contact - Concomitant participation in another trial that interferes with the normal conduct of the study and interpretation of the study results - Participant not proficient in German |
Country | Name | City | State |
---|---|---|---|
Switzerland | Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland | Bern | |
Switzerland | Department of Paediatric Endocrinology and Diabetes, University Children's Hospital Zurich | Zürich |
Lead Sponsor | Collaborator |
---|---|
Lia Bally | University of Zurich |
Switzerland,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Other | Total daily basal insulin dose | Mean total daily basal insulin dose infused | From the first day of the respective study period to 3 months thereafter | |
Other | Total daily bolus insulin dose | Mean total daily bolus insulin dose infused | From the first day of the respective study period to 3 months thereafter | |
Other | Percentage of time of closed-loop operation including engagement with specific functionalities | Utility evaluation | From the first day of the respective study period to 3 months thereafter | |
Other | Diabetes Distress Scale | Measurement of distress associated with the use of closed-loop insulin delivery using the Diabetes Distress questionnaire | At the predefined study visit 3 months after the start of the respective period. | |
Other | Hypoglycaemia confidence scale | HCS is a 9-item self-report scale that examines the degree to which people with diabetes feel able, secure, and comfortable regarding their ability to stay safe from hypoglycemic-related problems | At the predefined study visit 3 months after the start of the respective period. | |
Other | Psychosocial factors important to quality of life | These factors include anxiety, stress, depressions, etc. | At the predefined study visit 3 months after the start of the respective period. | |
Other | Food Frequency Questionnaire to assess dietary intake habits | Dietary intake (quantity and quality) | At the predefined study visit 3 months after the start of the respective period. | |
Other | Number of severe hypoglycaemia events | Hypoglycaemia requiring third-party assistance to administer carbohydrates or other resuscitative action | From the first day of the respective study period to 3 months thereafter | |
Other | Diabetic ketoacidosis | ADA definition | From the first day of the respective study period to 3 months thereafter | |
Other | Significant ketonaemia | Value > 3.0 mmol/L | From the first day of the respective study period to 3 months thereafter | |
Other | Nature and severity of adverse events | AE including SADE and SAE | From the first day of the respective study period to 3 months thereafter | |
Primary | Percentage of time with sensor glucose measurements between 3.9 and 10.0 mmol/L | The percentage of time with sensor glucose measurements between 3.9 and 10.0 mmol/L will be compared between both intervention arms. Primary analysis will be carried out according to a non-inferiority framework. | From the first day of the respective study period to 3 months thereafter | |
Secondary | Time spent with sensor glucose values above target (>10.0 mmol/L) | Percentage of time spent with sensor glucose values above target (>10.0 mmol/L) | From the first day of the respective study period to 3 months thereafter | |
Secondary | Time spent with sensor glucose values >13.9 mmol/L (%) | Percentage of time spent with sensor glucose values >13.9 mmol/L (%) | From the first day of the respective study period to 3 months thereafter | |
Secondary | Time spent with sensor glucose measurements < 3.9 mmol/L | The percentage of time with sensor glucose measurements < 3.9 mmol/L (%) | From the first day of the respective study period to 3 months thereafter | |
Secondary | Time spent with sensor glucose measurements < 3.0 mmol/L | The percentage of time with sensor glucose measurements < 3.0 mmol/L (%) | From the first day of the respective study period to 3 months thereafter | |
Secondary | Time spent with sensor glucose measurements between < 3.9 mmol/L and 7.8 mmol/L (%) | The percentage of time with sensor glucose between < 3.9 mmol/L and 7.8 mmol/L (%) | From the first day of the respective study period to 3 months thereafter | |
Secondary | Mean sensor glucose level (mmol/L) | Mean of all sensor glucose levels (mmol/L) | From the first day of the respective study period to 3 months thereafter | |
Secondary | HbA1c | Glycated hemoglobin A1c (%) | At baseline and at the predefined study visits (3 months after the start of the respective periods) | |
Secondary | Mean peak postprandial glucose | Mean peak postprandial glucose (mmol/L) assessed within 180min following main meals (defined as carbohydrate amounts >25g entered into the CamAPS app by the participants). | From the first day of the respective study period to 3 months thereafter | |
Secondary | Coefficient of sensor glucose variation (%) | Coefficient of sensor glucose variation (%) | From the first day of the respective study period to 3 months thereafter | |
Secondary | Standard deviation of sensor glucose variation (mmol/L) | Standard deviation of sensor glucose variation (mmol/L) | From the first day of the respective study period to 3 months thereafter | |
Secondary | Glucose Management Indicator (%) | Glucose Management Indicator (%) | From the first day of the respective study period to 3 months thereafter | |
Secondary | Number of clinically significant hypoglycaemia (number of events with sensor glucose <3.9 mmol/L for at least 15min) | Number of events with sensor glucose <3.9 mmol/L for at least 15min | From the first day of the respective study period to 3 months thereafter | |
Secondary | Extended hypoglycaemia event rate (number of events with sensor glucose <3.9 mmol/L lasting at least 120min) | Number of events with sensor glucose <3.9 mmol/L lasting at least 120min | From the first day of the respective study period to 3 months thereafter | |
Secondary | Extended hyperglycaemia event rate (number of events with sensor glucose >13.9 mmol/L lasting at least 120min) | Number of events with sensor glucose >13.9 mmol/L lasting at least 120min | From the first day of the respective study period to 3 months thereafter | |
Secondary | Proportion of participants with sensor glucose in the target range (3.9 - 10.0 mmol/L for >70% of the time. | Proportion of participants with sensor glucose in the target range (3.9 - 10.0 mmol/L for >70% of the time. | From the first day of the respective study period to 3 months thereafter |
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