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Evaluation of the Advanced Hybrid Closed Loop (AHCL) System in Type 1 Adults and Pediatrics Utilizing Lyumjev®

Primary Purpose

Type 1 Diabetes

Status
Recruiting
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
MiniMed 780G System
Sponsored by
Medtronic Diabetes
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Type 1 Diabetes

Eligibility Criteria

7 Years - 80 Years (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Age 7-80 years at time of screening.
  2. Has a clinical diagnosis of type 1 diabetes:

    1. 14-80 years of age: A clinical diagnosis of type 1 diabetes for 2 years or more as determined via medical record or source documentation by an individual qualified to make a medical diagnosis.
    2. 7-13 years of age: A clinical diagnosis of type 1 diabetes for 1 year or more as determined via medical record or source documentation by an individual qualified to make a medical diagnosis.
  3. Does not require a legally authorized representative to consent on their behalf due to mental or intellectual disability.
  4. Subject or parent/caregiver is literate and able to read the language offered in the pump or pump materials.
  5. Subject and/or legally authorized representative is willing to provide informed consent for participation.
  6. Is willing to perform fingerstick blood glucose measurements as needed.
  7. Is willing to wear the system continuously throughout the study.
  8. Must have a minimum daily insulin requirement (Total Daily Dose) of greater than or equal to 8 units and a maximum total daily dose of 250 units or less.
  9. Has a Glycosylated hemoglobin (HbA1c) less than 10% (as processed by Central Lab) at time of screening visit.

    Note: All HbA1c blood specimens will be sent to and tested by a National Glycohemoglobin Standardization Program (NGSP) certified Central Laboratory. HbA1c testing must follow NGSP standards.

  10. Has thyroid-stimulating hormone (TSH) in the normal range OR if the TSH is out of normal reference range, the Free T3 is below or within the lab's reference range and Free T4 is within the normal reference range.
  11. Uses pump therapy for greater than 6 months (with or without CGM experience) prior to screening
  12. Is willing to upload data from the study pump, must have Internet access, and a computer system, or compatible smartphone that meets the requirements for uploading the study pump.
  13. Is willing to take one of the following insulins and can financially support the use of insulin preparations as required during the run-in period:

    1. Humalog (insulin lispro injection)
    2. NovoLog (insulin aspart injection)
    3. Admelog(insulin lispro injection)
  14. Is willing to take Lyumjev insulin during the study period (supplied via Sponsor).

Exclusion Criteria:

  1. Has hypersensitivity to insulin lispro or one of the excipients in Lyumjev®
  2. Has a history of 2 or more episodes of severe hypoglycemia, which resulted in any the following during the 6 months prior to screening:

    1. Medical assistance (i.e., Paramedics, Emergency Room [ER] or Hospitalization)
    2. Coma
    3. Seizures
  3. Has been hospitalized or has visited the ER in the 6 months prior to screening resulting in a primary diagnosis of uncontrolled diabetes.
  4. Has had DKA in the last 6 months prior to screening visit.
  5. Will not tolerate tape adhesive in the area of sensor placement as assessed by a qualified individual.
  6. Has any unresolved adverse skin condition in the area of sensor placement (e.g., psoriasis, dermatitis herpetiformis, rash, Staphylococcus infection).
  7. Is female of child-bearing potential and result of pregnancy test is positive at screening.
  8. Is sexually active female of child-bearing potential and is not using a form of contraception deemed reliable by the investigator.
  9. Is female and plans to become pregnant during the course of the study
  10. Is being treated for hyperthyroidism at time of screening.
  11. Has diagnosis of adrenal insufficiency.
  12. Has taken any oral, injectable, or intravenous (IV) glucocorticoids within 8 weeks from time of screening visit, or plans to take any oral, injectable, or IV glucocorticoid during the course of the study.
  13. Is using hydroxyurea at time of screening or plans to use it during the study.
  14. 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.
  15. Is currently abusing illicit drugs.
  16. Is currently abusing marijuana.
  17. Is currently abusing prescription drugs.
  18. Is currently abusing alcohol.
  19. Using pramlintide (Symlin), DPP-4 inhibitor, liraglutide (Victoza or other GLP-1 agonists), metformin, canagliflozin (Invokana or other SGLT2 inhibitors) at time of screening.
  20. 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.
  21. Has elective surgery planned that requires general anesthesia during the course of the study.
  22. Has sickle cell disease, hemoglobinopathy; or has received red blood cell transfusion or erythropoietin within 3 months prior to time of screening.
  23. Plans to receive red blood cell transfusion or erythropoietin over the course of study participation.
  24. Is diagnosed with current eating disorder such as anorexia or bulimia.
  25. Has been diagnosed with chronic kidney disease that results in chronic anemia.
  26. Has a hematocrit that is below the normal reference range of lab used.
  27. Is on dialysis.
  28. Has serum creatinine of >2 mg/dL.
  29. Has celiac disease that is not adequately treated as determined by the investigator.
  30. Has had any of the following cardiovascular events within 1 year of screening: myocardial infarction, unstable angina, coronary artery bypass surgery, coronary artery stenting, transient ischemic attack, cerebrovascular accident, angina, congestive heart failure, or ventricular rhythm disturbances.
  31. Has had history of cardiovascular event 1 year or more from the time of screening without

    1. a normal EKG and stress test within 6 months prior to screening or during screening or
    2. clearance from a qualified physician prior to receiving the study devices if there is an abnormal EKG or stress test.
  32. Has 3 or more cardiovascular risk factors listed below without a normal EKG within 6 months prior to screening or during screening or clearance from a qualified physician if there is an abnormal EKG:

    • Age >35 years
    • Type 1 diabetes of >15 years' duration
    • Presence of any additional risk factor for coronary artery disease
    • Presence of microvascular disease (proliferative retinopathy or nephropathy, including microalbuminuria)
    • Presence of peripheral vascular disease
    • Presence of autonomic neuropathy
  33. Is a member of the research staff involved with the study.

Sites / Locations

  • Stanford University
  • Rady Children's Hospital San DiegoRecruiting
  • Barbara Davis Center for Childhood Diabetes
  • Barbara Davis Center
  • Yale UniversityRecruiting
  • East Coast Institute for Research (Memorial Hospital)
  • University of South Florida Diabetes CenterRecruiting
  • Atlanta Diabetes
  • East Coast Institute for Research - Macon
  • Endocrine Research Solutions
  • Rocky MountainRecruiting
  • Barry J Reiner MD LLCRecruiting
  • Mayo Clinic
  • International Diabetes Center
  • The Docs LLCRecruiting
  • Physicians East
  • Texas Diabetes
  • Diabetes and Glandular Disease Clinic, P.ARecruiting
  • Rainier Research

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

MiniMed 780G System Utilizing Insulin Lyumjev®

Arm Description

Subjects with insulin-requiring type 1 diabetes age 7-80 using the MiniMed 780G system with Insulin Lyumjev® for a period of three months.

Outcomes

Primary Outcome Measures

Primary Safety Endpoint for Age 18-80 - Change in HbA1c
Age 18-80: The overall mean change in HbA1c from baseline to end of 3-month study period. Non-inferiority test.
Primary Safety Endpoint for Age 7-17 - Change in HbA1c
Age 7-17: The overall mean change in HbA1c from baseline to end of 3-month study period. Non-inferiority test.
Primary Effectiveness Endpoint for Age 18-80 - Percent of Time in Range (TIR 70-180 mg/dL)
Age 18-80: The mean % of time in range (TIR 70-180 mg/dL). Non-inferiority test.
Primary Effectiveness Endpoint for Age 7-17 - Percent of Time in Range (TIR 70-180 mg/dL)
Age 7-17 : The mean % of time in range (TIR 70-180 mg/dL). Non-inferiority test.

Secondary Outcome Measures

Secondary Effectiveness Endpoint 1 for Age 18-80 - Percent of Time in Hypoglycemia (< 54 mg/dL)
Age 18-80: The mean % of time in hypoglycemia (< 54 mg/dL). Non-inferiority test.
Secondary Effectiveness Endpoint 1 for Age 7-17 - Percent of Time in Hypoglycemia (< 54 mg/dL)
Age 7-17: The mean % of time in hypoglycemia (< 54 mg/dL). Non-inferiority test.
Secondary Effectiveness Endpoint 2 for Age 18-80 - Percent of Time in Range (TIR 70-180 mg/dL)
Age 18-80: The mean % of time in range (TIR 70-180 mg/dL). Superiority test.
Secondary Effectiveness Endpoint 2 for Age 7-17 - Percent of Time in Range (TIR 70-180 mg/dL)
Age 7-17: The mean % of time in range (TIR 70-180 mg/dL). Superiority test.

Full Information

First Posted
April 5, 2022
Last Updated
October 9, 2023
Sponsor
Medtronic Diabetes
Collaborators
Eli Lilly and Company
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1. Study Identification

Unique Protocol Identification Number
NCT05325294
Brief Title
Evaluation of the Advanced Hybrid Closed Loop (AHCL) System in Type 1 Adults and Pediatrics Utilizing Lyumjev®
Official Title
Evaluation of the Advanced Hybrid Closed Loop (AHCL) System in Type 1 Adult and Pediatric Subjects Utilizing Lyumjev® Insulin Lispro-aabc
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
May 5, 2022 (Actual)
Primary Completion Date
December 1, 2023 (Anticipated)
Study Completion Date
December 1, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Medtronic Diabetes
Collaborators
Eli Lilly and Company

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
Yes

5. Study Description

Brief Summary
This US study will evaluate the safety and effectiveness of utilizing insulin Lyumjev® lispro-aabc in the MiniMed™ 780G System in Type 1 adult and pediatric subjects in a home setting to support product and system labeling.
Detailed Description
This study is a multi-center, single arm study in insulin-requiring adult and pediatric subjects with type 1 diabetes on the MiniMed™ 780G system using Lyumjev® insulin lispro-aabc and Medtronic Extended infusion set and reservoir. The run-in period and study period will be approximately 120 days long. A total of up to 250 subjects with insulin-requiring type 1 diabetes age 7-80 will be enrolled at up to 25 investigational centers across the United States in order to have at least 200 subjects enter the study period. Up to 125 subjects will be enrolled in the pediatric age group (7-17 years of age) and up to 125 in the adult age group (18 years or older).

6. Conditions and Keywords

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

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
MiniMed 780G System Utilizing Insulin Lyumjev®
Arm Type
Experimental
Arm Description
Subjects with insulin-requiring type 1 diabetes age 7-80 using the MiniMed 780G system with Insulin Lyumjev® for a period of three months.
Intervention Type
Device
Intervention Name(s)
MiniMed 780G System
Intervention Description
MiniMed™ 780G Insulin Pump, Guardian™ 4 Glucose Sensor, and Guardian 4 Transmitter; used with Insulin Lyumjev® insulin lispro-aabc
Primary Outcome Measure Information:
Title
Primary Safety Endpoint for Age 18-80 - Change in HbA1c
Description
Age 18-80: The overall mean change in HbA1c from baseline to end of 3-month study period. Non-inferiority test.
Time Frame
3 months
Title
Primary Safety Endpoint for Age 7-17 - Change in HbA1c
Description
Age 7-17: The overall mean change in HbA1c from baseline to end of 3-month study period. Non-inferiority test.
Time Frame
3 months
Title
Primary Effectiveness Endpoint for Age 18-80 - Percent of Time in Range (TIR 70-180 mg/dL)
Description
Age 18-80: The mean % of time in range (TIR 70-180 mg/dL). Non-inferiority test.
Time Frame
3 months
Title
Primary Effectiveness Endpoint for Age 7-17 - Percent of Time in Range (TIR 70-180 mg/dL)
Description
Age 7-17 : The mean % of time in range (TIR 70-180 mg/dL). Non-inferiority test.
Time Frame
3 months
Secondary Outcome Measure Information:
Title
Secondary Effectiveness Endpoint 1 for Age 18-80 - Percent of Time in Hypoglycemia (< 54 mg/dL)
Description
Age 18-80: The mean % of time in hypoglycemia (< 54 mg/dL). Non-inferiority test.
Time Frame
3 months
Title
Secondary Effectiveness Endpoint 1 for Age 7-17 - Percent of Time in Hypoglycemia (< 54 mg/dL)
Description
Age 7-17: The mean % of time in hypoglycemia (< 54 mg/dL). Non-inferiority test.
Time Frame
3 months
Title
Secondary Effectiveness Endpoint 2 for Age 18-80 - Percent of Time in Range (TIR 70-180 mg/dL)
Description
Age 18-80: The mean % of time in range (TIR 70-180 mg/dL). Superiority test.
Time Frame
3 months
Title
Secondary Effectiveness Endpoint 2 for Age 7-17 - Percent of Time in Range (TIR 70-180 mg/dL)
Description
Age 7-17: The mean % of time in range (TIR 70-180 mg/dL). Superiority test.
Time Frame
3 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
7 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age 7-80 years at time of screening. Has a clinical diagnosis of type 1 diabetes: 14-80 years of age: A clinical diagnosis of type 1 diabetes for 2 years or more as determined via medical record or source documentation by an individual qualified to make a medical diagnosis. 7-13 years of age: A clinical diagnosis of type 1 diabetes for 1 year or more as determined via medical record or source documentation by an individual qualified to make a medical diagnosis. Does not require a legally authorized representative to consent on their behalf due to mental or intellectual disability. Subject or parent/caregiver is literate and able to read the language offered in the pump or pump materials. Subject and/or legally authorized representative is willing to provide informed consent for participation. Is willing to perform fingerstick blood glucose measurements as needed. Is willing to wear the system continuously throughout the study. Must have a minimum daily insulin requirement (Total Daily Dose) of greater than or equal to 8 units and a maximum total daily dose of 250 units or less. Has a Glycosylated hemoglobin (HbA1c) less than 10% (as processed by Central Lab) at time of screening visit. Note: All HbA1c blood specimens will be sent to and tested by a National Glycohemoglobin Standardization Program (NGSP) certified Central Laboratory. HbA1c testing must follow NGSP standards. Has thyroid-stimulating hormone (TSH) in the normal range OR if the TSH is out of normal reference range, the Free T3 is below or within the lab's reference range and Free T4 is within the normal reference range. Uses pump therapy for greater than 6 months (with or without CGM experience) prior to screening Is willing to upload data from the study pump, must have Internet access, and a computer system, or compatible smartphone that meets the requirements for uploading the study pump. Is willing to take one of the following insulins and can financially support the use of insulin preparations as required during the run-in period: Humalog (insulin lispro injection) NovoLog (insulin aspart injection) Admelog(insulin lispro injection) Is willing to take Lyumjev insulin during the study period (supplied via Sponsor). Exclusion Criteria: Has hypersensitivity to insulin lispro or one of the excipients in Lyumjev® Has a history of 2 or more episodes of severe hypoglycemia, which resulted in any the following during the 6 months prior to screening: Medical assistance (i.e., Paramedics, Emergency Room [ER] or Hospitalization) Coma Seizures Has been hospitalized or has visited the ER in the 6 months prior to screening resulting in a primary diagnosis of uncontrolled diabetes. Has had DKA in the last 6 months prior to screening visit. Will not tolerate tape adhesive in the area of sensor placement as assessed by a qualified individual. Has any unresolved adverse skin condition in the area of sensor placement (e.g., psoriasis, dermatitis herpetiformis, rash, Staphylococcus infection). Is female of child-bearing potential and result of pregnancy test is positive at screening. Is sexually active female of child-bearing potential and is not using a form of contraception deemed reliable by the investigator. Is female and plans to become pregnant during the course of the study Is being treated for hyperthyroidism at time of screening. Has diagnosis of adrenal insufficiency. Has taken any oral, injectable, or intravenous (IV) glucocorticoids within 8 weeks from time of screening visit, or plans to take any oral, injectable, or IV glucocorticoid during the course of the study. Is using hydroxyurea at time of screening or plans to use it during the study. 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. Is currently abusing illicit drugs. Is currently abusing marijuana. Is currently abusing prescription drugs. Is currently abusing alcohol. Using pramlintide (Symlin), DPP-4 inhibitor, liraglutide (Victoza or other GLP-1 agonists), metformin, canagliflozin (Invokana or other SGLT2 inhibitors) at time of screening. 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. Has elective surgery planned that requires general anesthesia during the course of the study. Has sickle cell disease, hemoglobinopathy; or has received red blood cell transfusion or erythropoietin within 3 months prior to time of screening. Plans to receive red blood cell transfusion or erythropoietin over the course of study participation. Is diagnosed with current eating disorder such as anorexia or bulimia. Has been diagnosed with chronic kidney disease that results in chronic anemia. Has a hematocrit that is below the normal reference range of lab used. Is on dialysis. Has serum creatinine of >2 mg/dL. Has celiac disease that is not adequately treated as determined by the investigator. Has had any of the following cardiovascular events within 1 year of screening: myocardial infarction, unstable angina, coronary artery bypass surgery, coronary artery stenting, transient ischemic attack, cerebrovascular accident, angina, congestive heart failure, or ventricular rhythm disturbances. Has had history of cardiovascular event 1 year or more from the time of screening without a normal EKG and stress test within 6 months prior to screening or during screening or clearance from a qualified physician prior to receiving the study devices if there is an abnormal EKG or stress test. Has 3 or more cardiovascular risk factors listed below without a normal EKG within 6 months prior to screening or during screening or clearance from a qualified physician if there is an abnormal EKG: Age >35 years Type 1 diabetes of >15 years' duration Presence of any additional risk factor for coronary artery disease Presence of microvascular disease (proliferative retinopathy or nephropathy, including microalbuminuria) Presence of peripheral vascular disease Presence of autonomic neuropathy Is a member of the research staff involved with the study. Has used a MiniMed 780G pump prior to screening
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Thomas Troub
Phone
818 576 3142
Email
thomas.troub@medtronic.com
First Name & Middle Initial & Last Name or Official Title & Degree
Shannon Bondy
Phone
818 576 4912
Email
shannon.bondy@medtronic.com
Facility Information:
Facility Name
Stanford University
City
Palo Alto
State/Province
California
ZIP/Postal Code
94304
Country
United States
Individual Site Status
Active, not recruiting
Facility Name
Rady Children's Hospital San Diego
City
San Diego
State/Province
California
ZIP/Postal Code
92123
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Marla Hashiguchi
Email
mhashiguchi@rchsd.org
First Name & Middle Initial & Last Name & Degree
Carla Demeterco-Berggren, MD
Facility Name
Barbara Davis Center for Childhood Diabetes
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Individual Site Status
Active, not recruiting
Facility Name
Barbara Davis Center
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Individual Site Status
Active, not recruiting
Facility Name
Yale University
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06511
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Carol Alexandrescu
Email
carol.alexandrescu@yale.edu
First Name & Middle Initial & Last Name & Degree
Laura Nally, MD
Facility Name
East Coast Institute for Research (Memorial Hospital)
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32204
Country
United States
Individual Site Status
Active, not recruiting
Facility Name
University of South Florida Diabetes Center
City
Tampa
State/Province
Florida
ZIP/Postal Code
33612
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Elizabeth Doble
Email
edoble@usf.edu
First Name & Middle Initial & Last Name & Degree
Dorothy Shulman, MD
Facility Name
Atlanta Diabetes
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30318
Country
United States
Individual Site Status
Active, not recruiting
Facility Name
East Coast Institute for Research - Macon
City
Macon
State/Province
Georgia
ZIP/Postal Code
31210
Country
United States
Individual Site Status
Active, not recruiting
Facility Name
Endocrine Research Solutions
City
Roswell
State/Province
Georgia
ZIP/Postal Code
30076
Country
United States
Individual Site Status
Active, not recruiting
Facility Name
Rocky Mountain
City
Idaho Falls
State/Province
Idaho
ZIP/Postal Code
83404
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Kelsie Wetzel
Email
kelsie.wetzel@idahomed.com
First Name & Middle Initial & Last Name & Degree
David Liljenquist, MD
Facility Name
Barry J Reiner MD LLC
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21229
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Lee Bromberger
Email
reinerstudy.lee@gmail.com
First Name & Middle Initial & Last Name & Degree
Barry Reiner, MD
Facility Name
Mayo Clinic
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States
Individual Site Status
Active, not recruiting
Facility Name
International Diabetes Center
City
Saint Louis Park
State/Province
Minnesota
ZIP/Postal Code
55416
Country
United States
Individual Site Status
Active, not recruiting
Facility Name
The Docs LLC
City
Las Vegas
State/Province
Nevada
ZIP/Postal Code
89113
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Carlos Torres, MD
Email
torres@thedocs.md
First Name & Middle Initial & Last Name & Degree
Asheesh Dewan, MD
Facility Name
Physicians East
City
Greenville
State/Province
North Carolina
ZIP/Postal Code
27834
Country
United States
Individual Site Status
Active, not recruiting
Facility Name
Texas Diabetes
City
Austin
State/Province
Texas
ZIP/Postal Code
78749
Country
United States
Individual Site Status
Active, not recruiting
Facility Name
Diabetes and Glandular Disease Clinic, P.A
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Terri Ryan
Email
terri.ryan@dgdclinic.com
First Name & Middle Initial & Last Name & Degree
Mark Kipnes, MD
Facility Name
Rainier Research
City
Renton
State/Province
Washington
ZIP/Postal Code
98057
Country
United States
Individual Site Status
Active, not recruiting

12. IPD Sharing Statement

Learn more about this trial

Evaluation of the Advanced Hybrid Closed Loop (AHCL) System in Type 1 Adults and Pediatrics Utilizing Lyumjev®

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