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Determination of Automated Multiple Insulin Dose Injections Settings Using the MDI/SMBG Advisor for Patients With Type 1 Diabetes -Data Collection, Observational & Proof of Concept Study

Primary Purpose

Type 1 Diabetes, Multiple Daily Injections

Status
Terminated
Phase
Not Applicable
Locations
Israel
Study Type
Interventional
Intervention
MPSA Algorithm
Sponsored by
Rabin Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Type 1 Diabetes

Eligibility Criteria

14 Years - 30 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Documented T1D for at least 1 year prior to study enrolment
  • Subjects aged ≥ 14 years and up to 30 years
  • A1c at inclusion ≥ 7 % and ≤ 10%
  • Using MDI of Basal/bolus therapy - basal insulin either Glargine/Lantus or Tregludec insulin and bolus short acting insulin analogs either aspart/Novorapid or Lispro/Humalog
  • Using SMBG or flash glucose monitoring (FGM/Libre) without using glucose trends
  • BMI SDS - below the 97th percentile for age
  • Subjects willing to follow study instructions

Exclusion Criteria:

  • An episode of diabetic keto-acidosis within the month prior to study entry and/or severe hypoglycemia resulting in seizure or loss of consciousness in the month prior to enrolment
  • Concomitant diseases/ treatment that influence metabolic control or any significant diseases /conditions including psychiatric disorders and substance abuse that in the opinion of the investigator is likely to affect the subject's ability to complete the study or compromise patient's safety
  • Participation in any other interventional study
  • Known or suspected allergy to trial products
  • Female subject who is pregnant or planning to become pregnant within the planned study duration
  • Subject needs to travel by air during the study duration

Sites / Locations

  • Schnider children medical center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

MPSA Algorithm

Arm Description

Insulin dosing will be adjusted using the MPSA algorithm

Outcomes

Primary Outcome Measures

Percentage of sensor glucose readings within range of 70-180 mg/dl

Secondary Outcome Measures

Percentage of sensor glucose readings below 54 mg/dl
HbA1c
Number of Severe Hypoglycemia events
Number of Diabetic Ketoacidosis events

Full Information

First Posted
July 9, 2019
Last Updated
November 29, 2020
Sponsor
Rabin Medical Center
Collaborators
DreaMed, Harvard University
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1. Study Identification

Unique Protocol Identification Number
NCT04014569
Brief Title
Determination of Automated Multiple Insulin Dose Injections Settings Using the MDI/SMBG Advisor for Patients With Type 1 Diabetes -Data Collection, Observational & Proof of Concept Study
Official Title
Determination of Automated Multiple Insulin Dose Injections Settings Using the MDI/SMBG Advisor for Patients With Type 1 Diabetes -Data Collection, Observational & Proof of Concept Study
Study Type
Interventional

2. Study Status

Record Verification Date
November 2020
Overall Recruitment Status
Terminated
Why Stopped
Investigators decision
Study Start Date
May 2, 2018 (Actual)
Primary Completion Date
September 1, 2020 (Actual)
Study Completion Date
September 1, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Rabin Medical Center
Collaborators
DreaMed, Harvard University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The MDI (Multiple Daily Injections) plus SMBG |(Self Monitoring Blood Glucose) Advisor (MPSA) is a software product that is designed to assist in insulin dosage decision making for subjects with T1DM using multiple daily injection and SMBG. The study will focus on the development, validation and eventually testing of the MPSA algorithm use. The major objective of the project is to develop an algorithm that will be able to optimize treatment plan parameters of MDI patients who use SMBG as glucose monitoring method. The clinical study has two segments. Segment A is an observational study needed for the development of the algorithm (this segment was already completed at the time of the registration) and Segment B is a proof of concept interventional study to validate the algorithm's Safety and Efficacy. Up to 20 patients using MDI and SMBG or Flash Glucose Monitoring (FGM) without using glucose trends will be enrolled to this proof of concept study. The study will evaluate the algorithm use for a period of 11 weeks. Post screening, patients will undergo a two weeks run-in period while using MDI and SMBG or FGM (patients that do not use FGM will be provided with blinded Libre Flash to be used during the run-in period and 2 weeks prior to arriving to end of study visit). Then, patients will undergo insulin treatment plan changes every week for 7 weeks. At the first 3 weeks insulin dose adjustments will be done for basal insulin dose only, week 4 will be without changes, and in the next 3 weeks the carbohydrate ratio will be amended. No recommendations will be given during the last two weeks of the study. These two weeks will be used for data analysis. Each recommendation of the Advisor will be approved by a physician before implementation. Glucose outcomes will be evaluated comparing the two weeks run-in period to the last two weeks of the study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Type 1 Diabetes, Multiple Daily Injections

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
6 (Actual)

8. Arms, Groups, and Interventions

Arm Title
MPSA Algorithm
Arm Type
Experimental
Arm Description
Insulin dosing will be adjusted using the MPSA algorithm
Intervention Type
Device
Intervention Name(s)
MPSA Algorithm
Intervention Description
Insulin dosing will be adjusted using the MPSA Algorithm
Primary Outcome Measure Information:
Title
Percentage of sensor glucose readings within range of 70-180 mg/dl
Time Frame
Final visit (day 42)
Secondary Outcome Measure Information:
Title
Percentage of sensor glucose readings below 54 mg/dl
Time Frame
Final visit (day 42)
Title
HbA1c
Time Frame
Final visit (day 42)
Title
Number of Severe Hypoglycemia events
Time Frame
Final visit (day 42)
Title
Number of Diabetic Ketoacidosis events
Time Frame
Final visit (day 42)
Other Pre-specified Outcome Measures:
Title
Percentage of sensor glucose readings below 70 mg/dl
Time Frame
Final visit (day 42)
Title
Percentage of sensor glucose readings below 50mg/dl
Time Frame
Final visit (day 42)
Title
Percentage of sensor glucose readings above 180mg/dl
Time Frame
Final visit (day 42)
Title
Percentage of sensor glucose readings above 250mg/dl
Time Frame
Final visit (day 42)
Title
Number of unexplained hyperglycemic events
Time Frame
Final visit (day42)
Title
Area above the curve of 180mg/dl
Time Frame
Final visit (day 42)
Title
Area above the curve >180mg/dl
Time Frame
Final visit (day 42)
Title
Area under the curve of 70mg/dl
Time Frame
Final visit (day 42)
Title
Area under the curve <70mg/dl
Time Frame
Final visit (day 42)
Title
Mean sensor blood glucose
Time Frame
Final visit (day42)
Title
Glucose variability measured by SD (standard deviation)
Time Frame
Final visit (day 42)
Title
Number of recommendations for changes in settings per patient
Time Frame
Final visit (day 42)
Title
Number of recommendations for changes in setting per iteration
Time Frame
Final visit (day 42)
Title
Number of physician override advisor recommendations
Time Frame
Final visit (day 42)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
14 Years
Maximum Age & Unit of Time
30 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Documented T1D for at least 1 year prior to study enrolment Subjects aged ≥ 14 years and up to 30 years A1c at inclusion ≥ 7 % and ≤ 10% Using MDI of Basal/bolus therapy - basal insulin either Glargine/Lantus or Tregludec insulin and bolus short acting insulin analogs either aspart/Novorapid or Lispro/Humalog Using SMBG or flash glucose monitoring (FGM/Libre) without using glucose trends BMI SDS - below the 97th percentile for age Subjects willing to follow study instructions Exclusion Criteria: An episode of diabetic keto-acidosis within the month prior to study entry and/or severe hypoglycemia resulting in seizure or loss of consciousness in the month prior to enrolment Concomitant diseases/ treatment that influence metabolic control or any significant diseases /conditions including psychiatric disorders and substance abuse that in the opinion of the investigator is likely to affect the subject's ability to complete the study or compromise patient's safety Participation in any other interventional study Known or suspected allergy to trial products Female subject who is pregnant or planning to become pregnant within the planned study duration Subject needs to travel by air during the study duration
Facility Information:
Facility Name
Schnider children medical center
City
Petach-Tikva
Country
Israel

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Determination of Automated Multiple Insulin Dose Injections Settings Using the MDI/SMBG Advisor for Patients With Type 1 Diabetes -Data Collection, Observational & Proof of Concept Study

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