Type 1 Diabetes Clinical Trial
Official title:
Multi-center, Randomized, Parallel, Adaptive, Controlled Trial in Adult and Pediatric Patients With Type 1 Diabetes Using Hybrid Closed Loop System and Control (CSII, MDI and SAP) at Home
NCT number | NCT02748018 |
Other study ID # | CEP 304 |
Secondary ID | |
Status | Recruiting |
Phase | N/A |
First received | |
Last updated | |
Start date | May 25, 2017 |
Est. completion date | September 2024 |
The purpose of this study is to evaluate the safety and effectiveness of the Hybrid Closed Loop system (HCL) in adult and pediatric patients with type 1 diabetes in the home setting. A diverse population of patients with type 1 diabetes will be studied. The study population will have a large range for duration of diabetes and glycemic control, as measured by glycosylated hemoglobin (A1C). They will be enrolled in the study regardless of their prior diabetes regimen, including using Multiple Daily Injections (MDI), Continuous Subcutaneous Insulin Infusion (CSII) or Sensor-Augmented Pump therapy (SAP)
Status | Recruiting |
Enrollment | 280 |
Est. completion date | September 2024 |
Est. primary completion date | March 2024 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 2 Years to 80 Years |
Eligibility | Inclusion Criteria 1. Subject is age 2-80 years at time of screening 1. US, Canada, Australia and New Zealand: Subjects 2-80 years of age will be allowed to enroll in the post approval study. 2. Europe: Only subjects =7 years of age are allowed to enroll in the post-market study. 2. Subjects who are 2-21 years are determined by the investigator to have the appropriate, requisite support (family, caregiver or social network) to successfully participate in this study 3. Subject must have a minimum daily insulin requirement (Total Daily Dose) of equal to or greater than 8 units/day 4. Subjects who are determined by the investigator to be psychologically sound in order to successfully participate in this study 5. Subject has been diagnosed with type 1 diabetes for at least three months Note: Determination of classification for diabetes will be based on American Diabetes Association Clinical Practice Guidelines accounting for several patient characteristics such as: age of onset, patient's weight or BMI, history of diabetic ketoacidosis, history of therapy management, if available in the medical records. 6. Subject must be on one of the following management therapies: 1. Multiple daily injections defined by use of rapid analogue with meals and approved long acting analogue (e.g. detemir or glargine) with or without CGM 2. Insulin pump therapy with or without CGM 7. Subject is willing to perform = 4 finger stick blood glucose measurements daily 8. Subject is willing to perform required study procedures 9. Subject is willing to wear the system continuously throughout the study for at least 80% of the time. 10. Subject is willing to upload data at least weekly from the study pump/meter, must have Internet access and a computer system that meets the requirements for uploading the study pump/meter for data collection 11. Subject must be willing to use the study glucose meter system (i.e. along with study meter strips). 12. If subject has celiac disease, it has been adequately treated as determined by the investigator 13. Subject with the diagnosis of myocardial infarction, unstable angina, coronary artery bypass surgery, coronary artery stenting, transient ischemic attack, cerebrovascular accident, angina, congestive heart failure, ventricular rhythm disturbances or thromboembolic disease, within 1 year of screening, will be included in the study with the consent of the Investigator 14. Subject is willing to take one of the following insulins and can financially afford to use either of the 2 insulin preparations throughout the course of the study (i.e. co-payments for insulin with insurance or able to pay full amount) 1. Humalog® (insulin lispro injection) 2. NovoLog® (insulin aspart) Exclusion Criteria: 1. Subject participated in any Closed Loop study in the past. 2. Subject is unable to tolerate tape adhesive in the area of sensor placement 3. Subject has any unresolved adverse skin condition in the area of sensor placement (e.g., psoriasis, rash, Staphylococcus infection) or area of infusion set placement 4. Women of child-bearing potential who have a positive pregnancy test at screening or plan to become pregnant during the course of the study 5. Subject is being treated for hyperthyroidism at time of screening 6. Subject has an abnormality (out of reference range) in thyroid-stimulating hormone (TSH) at time of screening visit. TSH is not required for subjects 2-13 years of age. 7. Subject has taken any oral, injectable, or IV glucocorticoids within 8 weeks from time of screening visit, or plans to take any oral, injectable, or IV glucocorticoids during the course of the study. 8. Subject is actively participating in an investigational study (drug or device) wherein he/she has received treatment from an investigational study drug or investigational study device in the last 2 weeks 9. Subject is currently abusing illicit drugs or marijuana 10. Subject is currently abusing prescription drugs 11. Subject is currently abusing alcohol 12. Subject is using pramlintide (Symlin), SGLT2 inhibitors, GLP agonists, biguanides, DPP-4 inhibitors or sulfonylureas at time of screening 13. Subject is using hydroxyurea at the time of screening or plans to use it during the study 14. Subject has a history of visual impairment which would not allow subject to participate in the study and perform all study procedures safely, as determined by the investigator 15. Subject has a sickle cell disease, hemoglobinopathy; or has received red blood cell transfusion or erythropoietin within 3 months prior to time of screening 16. Subject plans to receive red blood cell transfusion or erythropoietin over the course of study participation 17. Subject diagnosed with current moderate to severe eating disorder such as anorexia or bulimia 18. Subject has been diagnosed with chronic kidney disease requiring dialysis or resulting in chronic anemia 19. Subjects who are currently being actively treated for cancer. 20. Subject who is designated as a research staff member for this study |
Country | Name | City | State |
---|---|---|---|
Canada | Westminster Endocrine & Diabetes Research Society | New Westminster | British Columbia |
Canada | Children's Hospital of Eastern Ontario | Ottawa | |
France | Hôpital Necker Enfants Malades | Paris | |
France | HCL - Lyon Sud | Pierre-Bénite | |
Germany | Diabeteszentrum für Kinder und Jugendliche, Kinder- und Jugendkrankenhaus Auf der Bult | Hannover | |
Italy | A.S.S.T. Spedali Civili | Brescia | |
New Zealand | New Zealand Clinical Research | Christchurch | |
New Zealand | Dunedin Public Hospital | Dunedin | |
Spain | Hospital Universitario Virgen del Rocío | Sevilla | |
Sweden | Dept Internal Medicine, Örebro University Hospital | Örebro | |
United Kingdom | Cambridge University Hospitals NHS Foundation Trust - Addenbrooke's Hospital | Cambridge | |
United States | University of Michigan | Ann Arbor | Michigan |
United States | Atlanta Diabetes Associates | Atlanta | Georgia |
United States | Barbara Davis Center | Aurora | Colorado |
United States | Texas Diabetes & Endocrinology | Austin | Texas |
United States | Grunberger Diabetes Institute | Bloomfield Hills | Michigan |
United States | IDERC | Des Moines | Iowa |
United States | Texas Children's Hospital / Baylor University | Houston | Texas |
United States | Rocky Mountain Diabetes | Idaho Falls | Idaho |
United States | Indiana University Health Riley Hospital for Children | Indianapolis | Indiana |
United States | Scripps Health System | La Jolla | California |
United States | Initernational Diabetes Center | Minneapolis | Minnesota |
United States | International Diabetes Center | Minneapolis | Minnesota |
United States | Yale School of Medicine | New Haven | Connecticut |
United States | Stanford University | Palo Alto | California |
United States | Rainier Clinical Research | Renton | Washington |
United States | Mayo Clinic | Rochester | Minnesota |
United States | Endocrine Research Solutions | Roswell | Georgia |
United States | Center of Excellence in Diabetes & Endocrinology | Sacramento | California |
United States | Washington University St. Louis | Saint Louis | Missouri |
United States | Diabetes and Glandular Disease Clinic, P.A. | San Antonio | Texas |
United States | Sansum Diabetes Research Institute | Santa Barbara | California |
United States | University of Washington | Seattle | Washington |
United States | Sanford Health | Sioux Falls | South Dakota |
United States | SUNY Upstate Medical University | Syracuse | New York |
United States | University of South Florida Diabetes Center | Tampa | Florida |
United States | SoCal Diabetes | Torrance | California |
United States | Diablo Clinical Research | Walnut Creek | California |
Lead Sponsor | Collaborator |
---|---|
Medtronic Diabetes |
United States, Canada, France, Germany, Italy, New Zealand, Spain, Sweden, United Kingdom,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | CSII Cohort: change of A1C (?A1C) for subjects with baseline A1c > 8% | CSII Cohort: Change in A1C from baseline to the end of the six-month treatment period, defined as A1C measured at the six-month treatment visit minus A1C measured at the randomization visit. This is only for subjects with baseline A1c > 8% | 6 months | |
Primary | CSII Cohort: Time in Hypoglycemic Range for subjects with baseline A1c = 8% | CSII Cohort: Time with sensor glucose (SG) below 70 mg/dL (3.9mmol/L) during the six-month study period. This is only for subjects with baseline A1c = 8% | 6 months | |
Primary | MDI Cohort: change of A1C (?A1C) for subjects with baseline A1c > 8% | MDI Cohort: Change in A1C from baseline to the end of the six-month treatment period, defined as A1C measured at the six-month treatment visit minus A1C measured at the randomization visit. This is only for subjects with baseline A1c > 8% | 6 months | |
Primary | MDI Cohort: Time in Hypoglycemic Range for subjects with baseline A1c = 8% | MDI Cohort: Time with sensor glucose (SG) below 70 mg/dL (3.9mmol/L) during the six-month study period. This is only for subjects with baseline A1c = 8% | 6 months | |
Primary | SAP Cohort: change of A1C (?A1C) for subjects with baseline A1c > 8% | SAP Cohort: Change in A1C from baseline to the end of the six-month treatment period, defined as A1C measured at the six-month treatment visit minus A1C measured at the randomization visit. This is only for subjects with baseline A1c > 8% | 6 months | |
Primary | SAP Cohort: Time in Hypoglycemic Range for subjects with baseline A1c = 8% | SAP Cohort: Time with sensor glucose (SG) below 70 mg/dL (3.9mmol/L) during the six-month study period. This is only for subjects with baseline A1c = 8% | 6 months | |
Secondary | CSII Cohort: Time in Hypoglycemic Range for subjects with baseline A1c > 8% | CSII Cohort: Time with sensor glucose (SG) below 70 mg/dL (3.9mmol/L) during the six-month study period. This is only for subjects with baseline A1c > 8% | 6 months | |
Secondary | CSII Cohort: Change in A1C (?A1C) for subjects with baseline A1c = 8% | CSII Cohort: Change in A1C from baseline to the end of the six-month treatment period, defined as A1C measured at the six-month treatment visit minus A1C measured at the randomization visit. This is only for subjects with baseline A1c = 8% | 6 months | |
Secondary | CSII Cohort: Time in Hypoglycemic Range during Night for all subjects | CSII Cohort: Time with SG below 70 mg/dL (3.9mmol/L) during Night for all subjects | 6 months | |
Secondary | CSII Cohort: Time in Target Range 70mg/dL (3.9mmol/L) - 180 mg/dL (10.0mmol/L) during Night for all subjects | CSII Cohort: Time in target range measures the time with SG in target range 70mg/dL (3.9mmol/L) - 180 mg/dL (10.0mmol/L) during Night for all subjects | 6 months | |
Secondary | CSII Cohort: Time in Target Range 70mg/dL (3.9mmol/L) - 180 mg/dL (10.0mmol/L) during Day and Night for all subjects | CSII Cohort: Time in target range measures the time with SG in target range 70mg/dL (3.9mmol/L) - 180 mg/dL (10.0mmol/L) during Day and Night for all subjects | 6 months | |
Secondary | CSII Cohort: Time in Hypoglycemic Range during Day and Night for all subjects | CSII Cohort: Time with SG below 70 mg/dL (3.9mmol/L) during Day and Night for all subjects | 6 months | |
Secondary | CSII Cohort: Change in A1C for all subjects | CSII Cohort: Change in A1C from baseline to the end of the six-month treatment period, defined as A1C measured at the six-month treatment visit minus A1C measured at the randomization visit for all subjects | 6 months | |
Secondary | MDI Cohort: Time in Hypoglycemic Range for subjects with baseline A1c > 8% | MDI Cohort: Time with sensor glucose (SG) below 70 mg/dL (3.9mmol/L) during the six-month study period. This is only for subjects with baseline A1c > 8% | 6 months | |
Secondary | MDI Cohort: Change in A1C (?A1C) for subjects with baseline A1c = 8% | MDI Cohort: Change in A1C from baseline to the end of the six-month treatment period, defined as A1C measured at the six-month treatment visit minus A1C measured at the randomization visit. This is only for subjects with baseline A1c = 8% | 6 months | |
Secondary | MDI Cohort: Time in Hypoglycemic Range during Night for all subjects | MDI Cohort: Time with SG below 70 mg/dL (3.9mmol/L) during Night for all subjects | 6 months | |
Secondary | MDI Cohort: Time in Target Range 70mg/dL (3.9mmol/L) - 180 mg/dL (10.0mmol/L) during Night for all subjects | MDI Cohort: Time in target range measures the time with SG in target range 70mg/dL (3.9mmol/L) - 180 mg/dL (10.0mmol/L) during Night for all subjects | 6 months | |
Secondary | MDI Cohort: Time in Target Range 70mg/dL (3.9mmol/L) - 180 mg/dL (10.0mmol/L) during Day and Night for all subjects | MDI Cohort: Time in target range measures the time with SG in target range 70mg/dL (3.9mmol/L) - 180 mg/dL (10.0mmol/L) during Day and Night for all subjects | 6 months | |
Secondary | MDI Cohort: Time in Hypoglycemic Range during Day and Night for all subjects | MDI Cohort: Time with SG below 70 mg/dL (3.9mmol/L) during Day and Night for all subjects | 6 months | |
Secondary | MDI Cohort: Change in A1C for all subjects | MDI Cohort: Change in A1C from baseline to the end of the six-month treatment period, defined as A1C measured at the six-month treatment visit minus A1C measured at the randomization visit for all subjects | 6 months | |
Secondary | SAP Cohort: Time in Hypoglycemic Range for subjects with baseline A1c > 8% | SAP Cohort: Time with sensor glucose (SG) below 70 mg/dL (3.9mmol/L) during the six-month study period. This is only for subjects with baseline A1c > 8% | 6 months | |
Secondary | SAP Cohort: Change in A1C (?A1C) for subjects with baseline A1c = 8% | SAP Cohort: Change in A1C from baseline to the end of the six-month treatment period, defined as A1C measured at the six-month treatment visit minus A1C measured at the randomization visit. This is only for subjects with baseline A1c = 8% | 6 months | |
Secondary | SAP Cohort: Time in Hypoglycemic Range during Night for all subjects | SAP Cohort: Time with SG below 70 mg/dL (3.9mmol/L) during Night for all subjects | 6 months | |
Secondary | SAP Cohort: Time in Target Range 70mg/dL (3.9mmol/L) - 180 mg/dL (10.0mmol/L) during Night for all subjects | SAP Cohort: Time in target range measures the time with SG in target range 70mg/dL (3.9mmol/L) - 180 mg/dL (10.0mmol/L) during Night for all subjects | 6 months | |
Secondary | SAP Cohort: Time in Target Range 70mg/dL (3.9mmol/L) - 180 mg/dL (10.0mmol/L) during Day and Night for all subjects | SAP Cohort: Time in target range measures the time with SG in target range 70mg/dL (3.9mmol/L) - 180 mg/dL (10.0mmol/L) during Day and Night for all subjects | 6 months | |
Secondary | SAP Cohort: Time in Hypoglycemic Range during Day and Night for all subjects | SAP Cohort: Time with SG below 70 mg/dL (3.9mmol/L) during Day and Night for all subjects | 6 months | |
Secondary | SAP Cohort: Change in A1C for all subjects | SAP Cohort: Change in A1C from baseline to the end of the six-month treatment period, defined as A1C measured at the six-month treatment visit minus A1C measured at the randomization visit for all subjects | 6 months |
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