Omnipod® 5 Automated Insulin Delivery System in Patients With Type 2 Diabetes

Type 2 Diabetes Mellitus Clinical Trial

Official title:

Evaluating the Safety and Effectiveness of the Omnipod® 5 Automated Insulin Delivery System in Patients With Type 2 Diabetes

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04617795
• Other study ID #: OP5 in T2D Study G190270
• Status: Completed
• Phase: N/A
• Start date: November 23, 2020
• Est. completion date: March 6, 2022

Study information

• Verified date: June 2023
• Source: Insulet Corporation
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The study subjects will be separated into 2 groups, depending on their previous insulin therapy with approximately 50% of subjects from each group, continuous glucose monitoring (CGM) naive.

Group A will complete a 2-week Standard Therapy Phase followed by 8 weeks of Omnipod 5 system use.

Group B will complete a 2-week Standard Therapy Phase followed by 10 weeks of Omnipod 5 system use.

Group A and Group B will have an optional 6-month extension of Omnipod 5 system use

Description:

Basal-Bolus - Group A (N=12)

• 2 weeks standard therapy - using multiple daily injections (MDI) and Dexcom G6 continuous glucose monitoring (CGM) , followed by:

• 4 weeks Omnipod 5 system use in Automated Mode with optional bolus, followed by:

• 4 weeks Omnipod 5 system use in Automated Mode with simplified bolus

• 6-month optional extension using Automated Mode

Basal - Group B (N=12)

• 2 weeks standard therapy - using basal injection only and Dexcom G6 continuous glucose monitoring (CGM) , followed by:

• 2 weeks Omnipod 5 system use in Manual Mode with Dexcom G6 continuous glucose monitoring (CGM) - with fixed basal rate, no bolus, followed by:

• 4 weeks Omnipod 5 system use in Automated Mode with optional bolus, followed by:

• If % time in range 70-180 mg/dL during Automated Mode is ≤50%, 4 weeks Omnipod 5 system use in Automated Mode with simplified bolus, OR

• If % time in range 70-180 mg/dL during Automated Mode is >50%, 4 weeks Omnipod 5 system use in Automated Mode with optional bolus

• 6-month optional extension using Automated Mode

Recruitment information / eligibility

• Status: Completed
• Enrollment: 24
• Est. completion date: March 6, 2022
• Est. primary completion date: March 6, 2022
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 75 Years

Eligibility

Inclusion Criteria:

1. Age at time of consent 18-75 years

2. Diagnosed with type 2 diabetes on insulin therapy by injection: basal-bolus (12 subjects) or basal only (12 subjects) regimens

3. A1C 8.0-12.0%

4. Has not used an insulin pump within 3 months of screening

5. Willing to use only the following types of insulin during the study: Humalog, Novolog, Admelog or Apidra during the study

6. Maximum insulin dose of 200 units/day

7. Stable doses over the last 4 weeks of other glucose-lowering medications as determined by Investigator

8. Willing to wear the system continuously throughout the study

9. Deemed appropriate for pump therapy per investigator's assessment considering previous history of severe hypoglycemic and hyperglycemic events, and other comorbidities

10. Investigator has confidence that the subject has the cognitive ability and can successfully operate all study devices and can adhere to the protocol

11. Must be willing to use the Dexcom App on the Omnipod 5 PDM as the sole source of Dexcom data (except for the Dexcom Follow App) during Automated Mode

12. Subjects scoring = 4 on the Clarke Questionnaire must agree to have an overnight companion, defined as someone who resides in the same home or building as the study subject and who can be available overnight

13. Able to read and speak English fluently

14. Willing and able to sign the Informed Consent Form (ICF)

Exclusion Criteria:

1. A medical condition, which in the opinion of the investigator, would put the subject at an unacceptable safety risk

2. Planned major surgery during the study

3. History of severe hypoglycemia in the past 6 months

4. History of diabetic ketoacidosis (DKA) in the past 6 months, unrelated to an intercurrent illness, infusion set failure or initial diagnosis

5. Diagnosed with a blood dyscrasia or bleeding disorder

6. Plans to receive blood transfusion over the course of the study

7. Currently diagnosed with anorexia nervosa or bulimia

8. Currently on hemodialysis

9. History of adrenal insufficiency

10. Has taken oral or injectable steroids within the past 8-weeks or plans to take oral or injectable steroids during the study

11. Unable to tolerate adhesive tape or has any unresolved skin condition in sensor or pump placement

12. Plans to use insulin other than U-100 insulin during the Omnipod 5 phase of the study

13. Cardiac disease with functional status New York Heart Association Class III or IV or current or known history of coronary artery disease that is not stable with medical management, including unstable angina, or angina that prevents moderate exercise despite medical management, or a history of myocardial infarction, percutaneous coronary intervention, or coronary artery bypass grafting within the previous 12-months.

14. Pregnant or lactating, or is a woman of childbearing potential and not on acceptable form of birth control (acceptable includes abstinence, condoms, oral/injectable contraceptives, IUD, or implant)

15. Participation in another clinical study using an investigational drug or device other than the Omnipod 5 in the preceding 30-days or intends to participate during the study period

16. Unable to follow clinical protocol for the duration of the study or is otherwise deemed unacceptable to participate in the study per the investigator's clinical judgment

Related Conditions & MeSH terms

• Diabetes Mellitus
• Diabetes Mellitus, Type 2
• Type 2 Diabetes Mellitus

Intervention

Device:
• Omnipod 5 Automated Insulin Delivery System
The Omnipod 5 is a single hormone insulin delivery system intended for the management of diabetes in persons requiring insulin. Continuous subcutaneous insulin infusion may be delivered by user-defined settings (manual mode) or automatically adjusted in response to feedback from a continuous glucose monitor (CGM). The Omnipod 5 can automatically increase insulin delivery based on sensor glucose values from the continuous glucose monitor (CGM) and can decrease or suspend delivery of insulin when the glucose value falls below or is predicted to fall below predefined threshold values. The Omnipod 5 is designed to assist patients with diabetes in achieving glycemic targets set by their health care providers.

Locations

Country	Name	City	State
United States	Atlanta Diabetes	Atlanta	Georgia
United States	Emory University	Atlanta	Georgia
United States	University of California	Los Angeles	California
United States	International Diabetes Center	Saint Louis Park	Minnesota

Sponsors (1)

Lead Sponsor	Collaborator
Insulet Corporation

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Hyperglycemia	Overall percentage of time =250 mg/dL during all phases of Automated Mode	8-10 weeks and after 6-month optional extension
Primary	Hypoglycemia	Overall percentage of time <54 mg/dL during all phases of Automated Mode	8-10 weeks and after 6-month optional extension
Secondary	Percent of time in range 70-180 mg/dL	Glucose metric from study continuous glucose monitoring system	Automated Mode use (8-10 weeks and after 6-month optional extension) will be compared to the standard therapy phase (2 weeks) overall, separately for Group A and Group B
Secondary	Percent of time > 180 mg/dL	Glucose metric from study continuous glucose monitoring system	Automated Mode use (8-10 weeks and after 6-month optional extension) will be compared to the standard therapy phase (2 weeks) overall, separately for Group A and Group B
Secondary	Percent of time = 250 mg/dL	Glucose metric from study continuous glucose monitoring system	Automated Mode use (8-10 weeks and after 6-month optional extension) will be compared to the standard therapy phase (2 weeks) overall, separately for Group A and Group B
Secondary	Percent of time = 300 mg/dL	Glucose metric from study continuous glucose monitoring system	Automated Mode use (8-10 weeks and after 6-month optional extension) will be compared to the standard therapy phase (2 weeks) overall, separately for Group A and Group B
Secondary	Percent of time < 70 mg/dL	Glucose metric from study continuous glucose monitoring system	Automated Mode use (8-10 weeks and after 6-month optional extension) will be compared to the standard therapy phase (2 weeks) overall, separately for Group A and Group B
Secondary	Percent of time < 54 mg/dL	Glucose metric from study continuous glucose monitoring system	Automated Mode use (8-10 weeks and after 6-month optional extension) will be compared to the standard therapy phase (2 weeks) overall, separately for Group A and Group B
Secondary	Standard Deviation	Glucose metric from study continuous glucose monitoring system-measured glucose variability with the standard deviation	Automated Mode use (8-10 weeks and after 6-month optional extension) will be compared to the standard therapy phase (2 weeks) overall, separately for Group A and Group B
Secondary	Coefficient of Variation	Glucose metric from study continuous glucose monitoring system-measured glucose variability with the coefficient of variation	Automated Mode use (8-10 weeks and after 6-month optional extension) will be compared to the standard therapy phase (2 weeks) overall, separately for Group A and Group B
Secondary	Mean glucose	Glucose metric from study continuous glucose monitoring system	Automated Mode use (8-10 weeks and after 6-month optional extension) will be compared to the standard therapy phase (2 weeks) overall, separately for Group A and Group B
Secondary	Total daily Insulin (units)	Measure of insulin requirements	Automated Mode use (8-10 weeks and after 6-month optional extension) will be compared to the standard therapy phase (2 weeks) overall, separately for Group A and Group B
Secondary	Total daily insulin (units/kg)	Measure of insulin requirements	Automated Mode use (8-10 weeks and after 6-month optional extension) will be compared to the standard therapy phase (2 weeks) overall, separately for Group A and Group B
Secondary	Change in Hemoglobin A1c (HbA1c)	Measures average blood sugar levels over the past 3 months	End of study (8-10 weeks) and during extension (21-23 weeks and 24-26 weeks) compared to baseline (Days 57, 147, and 237 (Group A) or Days 71, 161, and 251 (Group B) compared to Day -30