Diabetes Clinical Trial
— AiDAPTOfficial title:
Automated Insulin Delivery Amongst Pregnant Women With Type 1 Diabetes
NCT number | NCT04938557 |
Other study ID # | 240380 |
Secondary ID | |
Status | Completed |
Phase | N/A |
First received | |
Last updated | |
Start date | September 26, 2019 |
Est. completion date | June 30, 2023 |
Verified date | December 2023 |
Source | Norfolk and Norwich University Hospitals NHS Foundation Trust |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
Evaluation of the biomedical and psychosocial impact of automated Closed-Loop (Artificial Pancreas) insulin delivery in women with type 1 diabetes during pregnancy
Status | Completed |
Enrollment | 124 |
Est. completion date | June 30, 2023 |
Est. primary completion date | April 30, 2022 |
Accepts healthy volunteers | No |
Gender | Female |
Age group | 18 Years to 45 Years |
Eligibility | Inclusion Criteria: 1. Between 18 and 45 years of age (inclusive). 2. A diagnosis of type 1 diabetes (T1D), as defined by WHO for at least 12 months. 3. A viable pregnancy confirmed by ultrasound, up to 13 weeks and 6 days gestation. 4. Currently on intensive insulin therapy (=3 injections or CSII). 5. Willingness to use the study devices throughout the trial. 6. HbA1c level =48 mmol/mol (=6.5%) at booking (first antenatal contact) and =86 mmol/mol (=10%) at point of randomization. 7. Able to provide informed consent. 8. Have access to email. Exclusion Criteria: 1. Non-type 1 diabetes. 2. Any other physical or psychological disease which, in the opinion of the investigator, is likely to interfere with the normal conduct and interpretation of the study results e.g. untreated coeliac disease or untreated hypothyroidism. 3. Current treatment with drugs known to interfere with glucose metabolism as judged by the investigator such as high dose systemic corticosteroids, non-selective beta-blockers and MAO inhibitors. 4. Known or suspected allergy against insulin. 5. Women with advanced nephropathy (eGFR <45), severe autonomic neuropathy, uncontrolled gastroparesis or severe proliferative retinopathy, as judged by the investigator, that is likely to interfere with the normal conduct of the study and interpretation of study results. 6. Very good or very poor glycaemic control i.e. first antenatal HbA1c <48 mmol/mol (<6.5%) and current HbA1c >10% (>86 mmol/mol). Women who enter pregnancy with HbA1c >10% (>86 mmol/mol) may participate if they achieve HbA1c =10% (=86 mmol/mol) before randomization. 7. Total daily insulin dose 1.5 IU/kg. 8. Severe visual or hearing impairment. 9. Unable to speak and understand English. |
Country | Name | City | State |
---|---|---|---|
United Kingdom | Norfolk and Norwich University Hospitals NHS Foundation Trust | Norwich | Norfolk |
Lead Sponsor | Collaborator |
---|---|
Norfolk and Norwich University Hospitals NHS Foundation Trust | Belfast Health and Social Care Trust, King's College London, University of Cambridge, University of East Anglia, University of Edinburgh, University of Glasgow, University of Leeds |
United Kingdom,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | The time spent with glucose levels between 3.5-7.8 mmol/L based on CGM measures (Time In Range TIR 3.5-7.8mmol/L) | The primary outcome is the percentage of time spent with glucose levels between 3.9-7.8 mmol/L based on CGM levels between 16 weeks gestation and delivery.as compared with standard self-directed insulin delivery in pregnant women with T1D. | Between 16 weeks gestation and delivery - an average of 18 weeks | |
Secondary | CGM glucose measures | The time spent with CGM glucose levels above and below target range, using the mean CGM glucose and CGM glucose variability measures (CV, SD). | Between 16 weeks gestation and delivery - an average of 18 weeks | |
Secondary | CGM glucose index (Low) | The Low Blood Glucose Index (LBGI) | Between 16 weeks gestation and delivery - an average of 18 weeks | |
Secondary | CGM glucose index (High) | High Blood Glucose Index (HBGI) measures | Between 16 weeks gestation and delivery - an average of 18 weeks | |
Secondary | HbA1c testing (Maternal) | To assess the change of HbA1c in the maternal level. | Blood samples will be collected at baseline, 24-26 weeks, 34-36 weeks | |
Secondary | Diabetic ketoacidosis. | The frequency and severity of diabetic ketoacidosis | An average of 24 weeks | |
Secondary | Severe hypoglycaemia episodes. | The frequency and severity of hypoglycaemia episodes defined as CGM glucose levels <3.5 mmol/L (level 1 hypoglycaemia) and <2.8 mmol/L (level 2 hypoglycaemia) for at least 15 minutes. Distinct episodes must be separated for at least 30 minutes. | An average of 24 weeks | |
Secondary | The number and severity of episodes of adverse device effect. | Adverse events including pregnancy loss, stillbirth, neonatal death | <24 weeks gestation until delivery - an average of 16 weeks | |
Secondary | Hospital length of stay (maternal). | Hospital length of stay (all admissions including the delivery admission) | Between 13 and 40 weeks - an average of 24 weeks | |
Secondary | Mode of delivery | How the infant is delivered, for example: vaginal, instrumental, elective caesarean section and emergency caesarean section) | At >34 weeks (delivery) | |
Secondary | Gestational age at delivery | The gestational age at delivery and indication for any preterm delivery (<37 weeks). Measured in years. | At >34 weeks (delivery) | |
Secondary | Infant birth weight (LGA) | Infant birth weight (customised birth weight percentile, incidence of large for gestational age (LGA). | At >34 weeks (delivery) | |
Secondary | Infant birth weight (SGA). | Infant birth weight (customised birth weight percentile, incidence of small for gestational age (SGA). | At >34 weeks (delivery) | |
Secondary | Neonatal morbidity (hypoglycaemia, jaundice, respiratory distress). | Neonatal morbidity including treatment for neonatal hypoglycaemia, neonatal jaundice and respiratory distress. | Between delivery and 40 weeks - an average of 6 weeks | |
Secondary | Neonatal intensive care unit (NICU) admission. | Neonatal intensive care unit (NICU) admission >24 hours | NICU admission after 24 hours | |
Secondary | Hospital length of stay (infant). | Hospital length of stay for the infant | Between delivery and 40 weeks - an average of 6 weeks |
Status | Clinical Trial | Phase | |
---|---|---|---|
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