Insulet Artificial Pancreas Free-Living IDE3
Primary Purpose
Type1 Diabetes Mellitus
Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Insulet automated glucose control system
Sponsored by
About this trial
This is an interventional device feasibility trial for Type1 Diabetes Mellitus focused on measuring T1D, Omnipod
Eligibility Criteria
Inclusion Criteria:
- Age at time of consent 2.0-85 years
- Individuals aged ≥6.0 must be diagnosed with type 1 diabetes for at least one year. Preschool children aged 2.0-5.9 years must be diagnosed with type 1 diabetes for at least 6 months. Diagnosis is based on investigator's clinical judgment.
- A1C <10% at screening
- Currently using U-100 rapid-acting insulin analogs with insulin pump or receiving multiple daily injections suitable for conversion to pump therapy for at least 3 months prior to study start
- Willing to use the study CGM device for the duration of the study
- Willing to use the Omnipod® Insulin Management System during the study
- Willing to perform all fingerstick BG testing with the study-approved glucose meter at the frequency specified in the study protocol or per investigator discretion
- Willing to participate in setpoint and meal challenges
- Willing to use carbohydrate counting for determination of meal boluses
- Willing to participate in moderate intensity exercise for at least 30 minutes per day
- Willing to refrain from use of acetaminophen and supplemental vitamin C (>2000 mg/daily) for the entire duration of participation in the study
- Willing and able to sign the Informed Consent Form (ICF) and/or has a parent/guardian willing and able to sign the ICF. Assent will be obtained from pediatric and adolescent subjects per State requirements.
Exclusion Criteria:
- One or more episodes of severe hypoglycemia requiring emergency room (ER) visit or hospitalization within the past 6 months
- One or more episodes of diabetic ketoacidosis requiring ER visit or hospitalization within the past 6 months
- Planning to start a non-insulin anti-diabetic medication during the study. If on non-insulin medication, dose must be stable in the previous 30 days.
- Using a basal insulin with a usual duration of insulin action > 36 hours
- 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)
- Dermatological conditions at the proposed sensor/pump wear sites that in the investigator's opinion could preclude ability to wear the Pod and/or the Dexcom sensor
- 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. Abnormal electrocardiogram consistent with increased risk of arrhythmia, ischemia, or prolonged QT interval (> 440 ms). Electrocardiogram is only required for subjects >50 years old or with diabetes duration >20 years.
- Stroke
- Known history of seizure disorder
- Known history of adrenal insufficiency
- Current renal or hepatic disease
- Untreated or unstable hypothyroidism or celiac disease (per investigator's judgment)
- Currently undergoing cancer treatment
- Currently undergoing systemic treatment with steroids or immunosuppressive medication
- Known history of any chronic infections that would interfere with participation in the study or place study personnel at undue risk due to blood-borne contaminants
- Current illness that would interfere with participation in the study
- Untreated or inadequately treated mental illness
- Current alcohol abuse per investigator's judgment
- Electrically-powered implants that may be susceptible to RF interference
- Currently participating in another clinical study using an investigational drug or device
- Recent (within the preceding 30 days) participation in a clinical study using an investigational drug
- Unable to follow the clinical protocol for the duration of the study or is otherwise deemed unacceptable to participate in the study per the investigator's clinical judgment.
Sites / Locations
- Stanford University
- University of Colorado Denver
- Yale University School of Medicine
Arms of the Study
Arm 1
Arm Type
Other
Arm Label
Supervised Free-Living
Arm Description
Subjects will undergo a 7±1 day outpatient, standard therapy phase during which sensor and insulin data will be collected. Subjects or their caregivers will manage their diabetes at home per their usual routine using the study CGM and remain on current MDI or pump therapy. This will be followed by a 5-day/4-night or from approximately 48 to 72 hours for children ages 2.0-5.9 years, hybrid closed-loop phase conducted in a supervised hotel/rental house setting, where subjects will participate in specific setpoint challenges, meal challenges, and exercise
Outcomes
Primary Outcome Measures
Percentage of time in hypoglycemic range (defined as < 70 mg/dL)
Percentage of time in hyperglycemic range (defined as ≥ 250 mg/dL)
Secondary Outcome Measures
Mean Glucose
Percentage of time < 50 mg/dL
Percentage of time < 54 mg/dL
Percentage of time < 60 mg/dL
Percentage of time > 180 mg/dL
Percentage of time ≥ 300 mg/dL
Percentage of time between 70-180 mg/dL
Percentage of time between 70-140 mg/dL
Standard deviation
Using CGM measurements, the Standard deviations will be reported for the entire hybrid closed-loop phase overall, as well as separately during the day (0700 - 2259h) and during the night (2300 - 0659h).
Coefficient of variation
Using CGM measurements, the Coefficient of variation will be reported for the entire hybrid closed-loop phase overall, as well as separately during the day (0700 - 2259h) and during the night (2300 - 0659h).
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03216460
Brief Title
Insulet Artificial Pancreas Free-Living IDE3
Official Title
Evaluating Glucose Control in Patients With Type 1 Diabetes Under Free-living Conditions With the Insulet Automated Glucose Control System: IDE3
Study Type
Interventional
2. Study Status
Record Verification Date
July 2019
Overall Recruitment Status
Completed
Study Start Date
February 4, 2019 (Actual)
Primary Completion Date
May 28, 2019 (Actual)
Study Completion Date
May 28, 2019 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Insulet Corporation
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Device Product Not Approved or Cleared by U.S. FDA
Yes
Data Monitoring Committee
No
5. Study Description
Brief Summary
Subjects will undergo a 7±1 day outpatient, standard therapy phase during which sensor and insulin data will be collected. Subjects or their caregivers will manage their diabetes at home per their usual routine using the study CGM and remain on current MDI or pump therapy. This will be followed by a 5-day/4-night or from approximately 48 to 72 hours for children ages 2.0-5.9 years, hybrid closed-loop phase conducted in a supervised hotel/rental house setting.
Detailed Description
The study schedule will consist of a standard therapy data collection week followed by a hybrid closed-loop phase.
Subjects will undergo a 7±1 day outpatient, standard therapy phase during which sensor and insulin data will be collected. Subjects or their caregivers will manage their diabetes at home per their usual routine using the study CGM and remain on current MDI or pump therapy. This will be followed by a 5-day/4-night or from approximately 48 to 72 hours for children ages 2.0-5.9 years, hybrid closed-loop phase conducted in a supervised hotel/rental house setting.
The hybrid closed-loop phase will begin prior to lunch on Study Day 1.
During the hybrid closed-loop phase, subjects will participate in specific setpoint challenges, meal challenges, and exercise.
Hybrid closed-loop will be discontinued approximately 5 hours after breakfast time on Study Day 5. Subjects will be asked to complete a post-study questionnaire regarding their experience with the system. Subjects will be discharged home when stable and all discharge criteria are met. Subjects will consume a snack or meal after discontinuation of hybrid closed-loop before they leave the study site.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Type1 Diabetes Mellitus
Keywords
T1D, Omnipod
7. Study Design
Primary Purpose
Device Feasibility
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Model Description
This study is a single-arm, multi-center, observational clinical study.
Masking
None (Open Label)
Allocation
N/A
Enrollment
120 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Supervised Free-Living
Arm Type
Other
Arm Description
Subjects will undergo a 7±1 day outpatient, standard therapy phase during which sensor and insulin data will be collected. Subjects or their caregivers will manage their diabetes at home per their usual routine using the study CGM and remain on current MDI or pump therapy. This will be followed by a 5-day/4-night or from approximately 48 to 72 hours for children ages 2.0-5.9 years, hybrid closed-loop phase conducted in a supervised hotel/rental house setting, where subjects will participate in specific setpoint challenges, meal challenges, and exercise
Intervention Type
Device
Intervention Name(s)
Insulet automated glucose control system
Intervention Description
Insulet AP (artificial pancreas) system, using the Omnipod® insulin management system, Dexcom G4Share® AP System and personalized model predictive control algorithm.
Primary Outcome Measure Information:
Title
Percentage of time in hypoglycemic range (defined as < 70 mg/dL)
Time Frame
96 hours
Title
Percentage of time in hyperglycemic range (defined as ≥ 250 mg/dL)
Time Frame
96 hours
Secondary Outcome Measure Information:
Title
Mean Glucose
Time Frame
96 hours
Title
Percentage of time < 50 mg/dL
Time Frame
96 hours
Title
Percentage of time < 54 mg/dL
Time Frame
96 hours
Title
Percentage of time < 60 mg/dL
Time Frame
96 hours
Title
Percentage of time > 180 mg/dL
Time Frame
96 hours
Title
Percentage of time ≥ 300 mg/dL
Time Frame
96 hours
Title
Percentage of time between 70-180 mg/dL
Time Frame
96 hours
Title
Percentage of time between 70-140 mg/dL
Time Frame
96 hours
Title
Standard deviation
Description
Using CGM measurements, the Standard deviations will be reported for the entire hybrid closed-loop phase overall, as well as separately during the day (0700 - 2259h) and during the night (2300 - 0659h).
Time Frame
96 hours
Title
Coefficient of variation
Description
Using CGM measurements, the Coefficient of variation will be reported for the entire hybrid closed-loop phase overall, as well as separately during the day (0700 - 2259h) and during the night (2300 - 0659h).
Time Frame
96 hours
10. Eligibility
Sex
All
Minimum Age & Unit of Time
2 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Age at time of consent 2.0-85 years
Individuals aged ≥6.0 must be diagnosed with type 1 diabetes for at least one year. Preschool children aged 2.0-5.9 years must be diagnosed with type 1 diabetes for at least 6 months. Diagnosis is based on investigator's clinical judgment.
A1C <10% at screening
Currently using U-100 rapid-acting insulin analogs with insulin pump or receiving multiple daily injections suitable for conversion to pump therapy for at least 3 months prior to study start
Willing to use the study CGM device for the duration of the study
Willing to use the Omnipod® Insulin Management System during the study
Willing to perform all fingerstick BG testing with the study-approved glucose meter at the frequency specified in the study protocol or per investigator discretion
Willing to participate in setpoint and meal challenges
Willing to use carbohydrate counting for determination of meal boluses
Willing to participate in moderate intensity exercise for at least 30 minutes per day
Willing to refrain from use of acetaminophen and supplemental vitamin C (>2000 mg/daily) for the entire duration of participation in the study
Willing and able to sign the Informed Consent Form (ICF) and/or has a parent/guardian willing and able to sign the ICF. Assent will be obtained from pediatric and adolescent subjects per State requirements.
Exclusion Criteria:
One or more episodes of severe hypoglycemia requiring emergency room (ER) visit or hospitalization within the past 6 months
One or more episodes of diabetic ketoacidosis requiring ER visit or hospitalization within the past 6 months
Planning to start a non-insulin anti-diabetic medication during the study. If on non-insulin medication, dose must be stable in the previous 30 days.
Using a basal insulin with a usual duration of insulin action > 36 hours
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)
Dermatological conditions at the proposed sensor/pump wear sites that in the investigator's opinion could preclude ability to wear the Pod and/or the Dexcom sensor
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. Abnormal electrocardiogram consistent with increased risk of arrhythmia, ischemia, or prolonged QT interval (> 440 ms). Electrocardiogram is only required for subjects >50 years old or with diabetes duration >20 years.
Stroke
Known history of seizure disorder
Known history of adrenal insufficiency
Current renal or hepatic disease
Untreated or unstable hypothyroidism or celiac disease (per investigator's judgment)
Currently undergoing cancer treatment
Currently undergoing systemic treatment with steroids or immunosuppressive medication
Known history of any chronic infections that would interfere with participation in the study or place study personnel at undue risk due to blood-borne contaminants
Current illness that would interfere with participation in the study
Untreated or inadequately treated mental illness
Current alcohol abuse per investigator's judgment
Electrically-powered implants that may be susceptible to RF interference
Currently participating in another clinical study using an investigational drug or device
Recent (within the preceding 30 days) participation in a clinical study using an investigational drug
Unable to follow the clinical protocol for the duration of the study or is otherwise deemed unacceptable to participate in the study per the investigator's clinical judgment.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Bruce Buckingham, MD
Organizational Affiliation
Stanford University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Stanford University
City
Palo Alto
State/Province
California
ZIP/Postal Code
94305
Country
United States
Facility Name
University of Colorado Denver
City
Denver
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Facility Name
Yale University School of Medicine
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06511
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
No
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Insulet Artificial Pancreas Free-Living IDE3
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