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Type 1 Diabetes clinical trials

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NCT ID: NCT02397265 Completed - Type 1 Diabetes Clinical Trials

Clinical Assessment of a Closed-loop System With Glucagon, Exercise and Mixed Meals

Start date: December 3, 2014
Phase: N/A
Study type: Interventional

The diabetes technology group at Imperial College have developed a bio-inspired artificial pancreas (BiAP) system which uses a control algorithm based on a mathematical model of beta-cell physiology. The algorithm is implemented on a miniature silicon microchip within a portable handheld device, which interfaces the components of the artificial pancreas. Development of closed-loop insulin delivery devices to intensify control without hypoglycaemia has been extensively reviewed and have shown encouraging results . However, they have not yet proven to be robust when challenged with uncertainty and the external challenges (such as mixed meal contents, physical exercise, physiological stress and intercurrent illness) that people with Type 1 Diabetes Mellitus (T1DM) may be exposed to outside the clinical environment. The principal research objective is to assess the safety and efficacy of a closed-loop system for T1DM compared to standard insulin pump therapy (open-loop). The primary outcome from the studies will be % time spent with a glucose concentration in the target range (3.9-10.0mmol/l). This outcome incorporates safety as it ensures subjects do not have low or high glucose excursions and is the principal measure of efficacy for closed-loop insulin delivery systems in the scientific literature. Other measured outcomes will be % time spent in euglycaemia (3.9-7.8mmol/l), % time spent in hypoglycaemia (<3.9mmol/l), % time spent in hyperglycaemia (>10mmol/l), mean venous blood and sensor glucose, glycaemic variability as measured by standard metrics (Standard Deviation, Continuous Overlapping Net Glycaemic Action, Lability Index, J-Index, Glycaemic Risk Assessment Diabetes Equation, Mean Of Daily Differences, Mean Amplitude of Glucose Excursion, Average Daily Risk Range, M-VALUE, Mean Average Glucose), glycaemic risk as measured by Low Blood Glucose Index (LBGI) and High Blood Glucose Index (HBGI), closed-loop error grid analysis, glucose area under the curve. All measures have been previously published and validated. This clinical trial protocol assesses the artificial pancreas system in three separate sub-studies: 1. In a bi-hormonal (insulin and glucagon) configuration 2. During and after exercise with bi-hormonal closed loop, and standard insulin opened loop 3. During and after meals of mixed composition with bi-hormonal closed loop, and standard insulin opened loop

NCT ID: NCT02389335 Completed - Type 1 Diabetes Clinical Trials

Roles of T Helper 1 Cytokines in Type 1 Diabetes

Start date: April 2013
Phase: N/A
Study type: Observational

The mechanism of β cell destruction in Type 1 diabetes is not exactly known, Our hyphotesis is that interferon gamma, interleukin-2 and tumor necrotizan factor alpha have impotant roles in β cell destruction.

NCT ID: NCT02384889 Completed - Type 1 Diabetes Clinical Trials

DFMO in Children With Type 1 Diabetes

Start date: April 2015
Phase: Phase 1
Study type: Interventional

This study is a multicenter, double-blind, placebo-controlled, 2:1 randomly assigned, phase 1 clinical trial for individuals with type 1 diabetes. It is a blinded dose-ranging study enrolling patients with new onset type 1 diabetes with documented continued residual C-peptide production. After a 4 week screening and run-in period during which eligibility will be determined and glycemic control optimized, subjects will have a 3-month double-masked treatment period with either DFMO or placebo. After a 3 month wash-out period the durability of effect will be assessed. Subjects will be randomly assigned (6 to DFMO; 3 to placebo in each cohort) to 1 of 4 sequential dose cohorts.

NCT ID: NCT02361606 Completed - Type 1 Diabetes Clinical Trials

An Internet Cognitive-Behavioral Intervention for Youth With Type 1 Diabetes - Participation and Efficacy

Start date: March 2009
Phase: N/A
Study type: Interventional

Adolescents are often reluctant to receive psychological help. The investigators developed a web-based cognitive behavioral self-help intervention for adolescents with type 1 diabetes. The investigators aimed to examine the participation rate and outcomes on glycemic control and quality of life.

NCT ID: NCT02359617 Completed - Type 1 Diabetes Clinical Trials

Continuous Glucose Sensing at the Site of Subcutaneous Insulin Administration

Start date: February 2013
Phase: N/A
Study type: Interventional

The study seeks to evaluate a novel treatment approach for performing continuous real-time glucose sensing and insulin delivery at the same subcutaneous tissue site.

NCT ID: NCT02351232 Completed - Type 1 Diabetes Clinical Trials

The Lira Pump Trial

Start date: February 2015
Phase: Phase 2/Phase 3
Study type: Interventional

A randomized placebo-controlled clinical trial investigating the effects of Liraglutide as an add-on to intensive insulin therapy in overweight insulin pump treated type 1 diabetes patients in suboptimal glycemic control.

NCT ID: NCT02350374 Completed - Type 1 Diabetes Clinical Trials

Carbohydrate Counting in Children and Adolescents With Type 1 Diabetes

Start date: November 17, 2014
Phase: N/A
Study type: Interventional

The total amount of carbohydrates (CHO) at meal consumed strongly predicts the glycemic response in children and adolescents with type 1 diabetes. Carbohydrate counting is a technique to adapt a dose of rapid acting insulin to the carbohydrate content of a meal. Thanks to this flexible insuline therapy, the glycemic control and the quality of life tend to improve. Carbohydrate counting is a recommended technique in the adult diabetic population. There is little data on the use of this methode in youth with diabetes. There are no studies on the change of carbohydrates content at meals in children and adolescents with diabetes practicing counting carbs, while it is the main interest of this technique. The aim of this study is to assess how children and adolescents with type 1 diabetes use the possibility to change their carbohydrate amount at each main meal when they use the counting carb method. The investigators hypothesize that children vary their amount of CHO greatly. This is an argument for using this technique in pediatrics

NCT ID: NCT02333539 Completed - Type 1 Diabetes Clinical Trials

Adherence Intervention to Promote Optimal Use of Insulin Pumps in Adolescents With Type 1 Diabetes

Pump It Up!
Start date: September 2012
Phase: N/A
Study type: Interventional

The overall objective of this study is to address the critical need of improving insulin pump adherence in adolescents with Type 1 Diabetes (T1D) by providing personalized intervention using evidence-based techniques during routine diabetes clinic visits at point of care.

NCT ID: NCT02325206 Completed - Type 1 Diabetes Clinical Trials

Phase 1 Study to Explore the Safety and Pharmacokinetics of DAPAglifozin in Adolescents and Adults With Type 1 Diabetes

DAPA-IIT1
Start date: December 2014
Phase: Phase 1
Study type: Interventional

Dapagliflozin has been effective at lowering glucose and hemoglobin A1c (HbA1C) in subjects with tpye 2 diabetes (T2DM), when studied as monotherapy as well as in combination with insulin or oral anti-diabetic medications.This lead to investigations if this therapy would also be of benefit in type 1 diabetes as intensive insulin therapy is associated with glucose fluctuations, hypoglycemia, weight gain, and subsequent insulin resistance, all of which may reduce efficacy. The purpose of the pilot study is to collect clinical data on the HbA1c-dependent effect of a single-dose of 10mg dapagliflozin on the insulin dose administered intravenously during a glucose-infusion and an oral mixed-meal for the ensuing 24 hours with blood glucose kept between 160 - 220 mg/dl. The first objective is to investigate the degree of insulin dose reduction 24 hours after a single dose of 10mg dapagliflozin in patients with type 1 diabetes Further objectives are to investigate - the effect on urinary glucose excretion - if this effect is influenced by baseline glycemic control - if dapagliflozin influences postprandial insulin need - if dapagliflozin is associated with elevated ß-hydroxybutyrate levels - PK after oral administration of 10mg dapagliflozin

NCT ID: NCT02325193 Completed - Type 1 Diabetes Clinical Trials

"MiniMed 640G System" User Evaluation With the Question of Reducing the Rate of Hypoglycemia

Start date: March 2015
Phase: N/A
Study type: Observational

The Minimed®640G system (MM640G) consists of a combination of insulin and glucose sensor for continuous glucose monitoring (CGM). Here, the glucose sensor transmits not only the continuous glucose data on the display of insulin pump but, in the case of hypoglycemia also interrupt their insulin delivery of pump. In the currently available system Paradigm®VEO, the interruption takes place at a settled threshold level. In difference in the new system MM640G the shutdown algorithm can already be proactive and help avoid hypoglycemia completely. The so called PLGM algorithm (predictive low glucose management) should be tested in the user evaluation. The main objective is to answer the question of reducing the rate of hypoglycemia by application of the new PLGM algorithm. Included are a total of 24 patients, aged 1-21 years, in three pediatric diabetes centers.