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Safety Evaluation of an Advanced Hybrid Closed Loop System Using Lyumjev With the Tandem t:Slim X2 Insulin Pump With Control-IQ Technology in Adults, Adolescents and Children With Type 1 Diabetes

Primary Purpose

Type 1 Diabetes

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
t:slim X2 insulin pump with Control-IQ technology 1.5
Sponsored by
Tandem Diabetes Care, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Type 1 Diabetes focused on measuring type 1 diabetes, Control-IQ Technology, lyumjev

Eligibility Criteria

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

Inclusion Criteria:

  1. Age 6 to <81 years
  2. Diagnosis of type 1 diabetes for at least 1 year
  3. Currently using Control-IQ technology for at least 3 months, with CGM data recorded indicative of system use (active closed loop) for at least 85% of the possible time in 14 days prior to enrollment
  4. Total daily insulin dose (TDD) at least 2 U/day
  5. HbA1c < 10.5%
  6. Residing full-time in the United States, with no anticipated travel outside the United States during the period of study participation.
  7. For participants <18 years old, living with one or more parent/legal guardian knowledgeable about emergency procedures for severe hypoglycemia and able to contact the participant in case of an emergency, and willing to use the Dexcom Follow app (with push notifications turned on) for the duration of the study.
  8. If >18 years old, participant has someone who lives within 30 minutes of them who is willing to be contacted if the study team can't reach the participant in case of a suspected medical emergency.
  9. Participant has agreed to participate in the study; and has read, understood and signed the informed consent form (ICF) and assent, if applicable; and has agreed to follow all study procedures, including:

    1. suspending use of any personal CGM for the duration of the clinical trial once the study CGM is in use
    2. switching to or continuing to use Humalog during the lead-in period
    3. switching to Lyumjev for the main study period.
    4. willing and able to perform the study exercise and meal challenges.
  10. Investigator has confidence that the participant can successfully operate all study devices and is capable of adhering to the protocol, including ability to respond to alerts and alarms, and to provide basic diabetes self-management.
  11. Participant and/or parent/legal guardian have the ability to read and understand English

Exclusion Criteria:

  1. More than 1 episode of diabetic ketoacidosis (DKA) in the past 6 months
  2. More than 1 episode of severe hypoglycemia (needing assistance) in the past 6 months
  3. Inpatient psychiatric treatment in the past 6 months
  4. History of drug abuse (defined as any illicit drug use) or history of alcohol abuse prior to screening or unwillingness to agree to abstain from illicit drugs throughout the study.
  5. For Female: Currently pregnant or planning to become pregnant during the time period of study participation

    1. A negative pregnancy test will be required for all females of child-bearing potential (menarchal)
    2. Counseling on appropriate birth control options will be provided to females with child-bearing potential in the event the participant does not have an acceptable plan.
  6. Adults lacking the capacity to provide consent and/or follow study procedures in the opinion of the investigator
  7. Concurrent use of any non-insulin glucose-lowering agent, other than metformin (for example, GLP-1 agonists, Symlin, DPP-4 inhibitors, SGLT-2 inhibitors, sulfonylureas).
  8. Hemophilia or any other bleeding disorder
  9. Hemoglobinopathy
  10. History of heart, liver, lung or kidney disease determined by investigator to interfere with the study
  11. History of allergic reaction to Humalog or Lyumjev
  12. Use of glucocorticoids, beta blockers or other medications determined by investigator to interfere with study
  13. Abnormal screening electrocardiogram consistent with increased risk during exercise, such as arrhythmia, ischemia, or prolonged QTc interval (>450 ms) (Screening ECG only required for participants age > 50 years, duration of diabetes > 20 years, or history of coronary artery disease)
  14. Significant chronic kidney disease (which could impact CGM accuracy in investigator's judgment) or hemodialysis
  15. History of adrenal insufficiency
  16. History of abnormal TSH consistent with hypothyroidism or hyperthyroidism that is not appropriately treated
  17. History of gastroparesis
  18. A condition, which in the opinion of the investigator or designee, would put the participant or study at risk
  19. Participation in another pharmaceutical or device trial at the time of enrollment or anticipated for during the time period of study participation
  20. Employed by, or having immediate family members employed by Tandem Diabetes Care, Inc., Eli Lilly and Co., or TypeZero Technologies, LLC, or having a direct supervisor at place of employment who is also directly involved in conducting the clinical trial (as a study investigator, coordinator, etc.); or having a first-degree relative who is directly involved in conducting the clinical trial

Sites / Locations

  • Children's Hospital Orange County
  • Stanford University
  • Barbara Davis Center
  • University of Florida
  • University of South Florida Diabetes Center
  • Northwestern University
  • Indiana University / Riley Hospital for Children
  • Iowa Diabetes and Endocrinology Research Center (IDERC)
  • Joslin Diabetes Center
  • Children's Mercy Hospital
  • Icahn School of Medicine at Mt. Sinai
  • Diabetes & Glandular Disease (DGD)
  • University of Virginia

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

t:slim X2 insulin pump with Control-IQ technology utilizing insulin Lyumjev®

Arm Description

Current Control-IQ technology users with type 1 diabetes, age 6-80, will use the t:slim X2 insulin pump with Control-IQ technology 1.5 and Lyumjev insulin for 3-months of outpatient use.

Outcomes

Primary Outcome Measures

Severe hypoglycemia
Number of severe hypoglycemia events (with cognitive impairment such that assistance of another individual is needed for treatment) during study compared with data on severe hypoglycemic events reported by T1D Exchange clinic registry
Diabetic ketoacidosis
Number of diabetic ketoacidosis events
Unanticipated adverse device effects
Number of unanticipated adverse device effects (UADE) events
Other serious adverse events
Number of other serious adverse events
Adverse drug reactions
Number of adverse drug reactions

Secondary Outcome Measures

All reportable adverse events
Number of reportable adverse events during the course of the study
CGM hypoglycemia outcomes: Overall % time <54 mg/dL
CGM overall percent time < 54 mg/dL
CGM hypoglycemia outcomes: Postprandial % time <54 mg/dL
CGM postprandial percent time < 54 mg/dL
CGM hypoglycemia outcomes: Overall % time <70 mg/dL
CGM overall percent time < 70 mg/dL
CGM hypoglycemia outcomes: Postprandial % time <70 mg/dL
CGM postprandial percent time < 70 mg/dL
CGM hypoglycemia outcomes: Rate of hypoglycemia events
Rate of hypoglycemia events defined as 15 or more consecutive minutes <54 mg/dL

Full Information

First Posted
May 19, 2022
Last Updated
August 3, 2023
Sponsor
Tandem Diabetes Care, Inc.
Collaborators
Eli Lilly and Company, Jaeb Center for Health Research
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1. Study Identification

Unique Protocol Identification Number
NCT05403502
Brief Title
Safety Evaluation of an Advanced Hybrid Closed Loop System Using Lyumjev With the Tandem t:Slim X2 Insulin Pump With Control-IQ Technology in Adults, Adolescents and Children With Type 1 Diabetes
Official Title
Safety Evaluation of an Advanced Hybrid Closed Loop System Using Lyumjev With the Tandem t:Slim X2 Insulin Pump With Control-IQ Technology in Adults, Adolescents and Children With Type 1 Diabetes
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Completed
Study Start Date
August 31, 2022 (Actual)
Primary Completion Date
August 2, 2023 (Actual)
Study Completion Date
August 2, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Tandem Diabetes Care, Inc.
Collaborators
Eli Lilly and Company, Jaeb Center for Health Research

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
Prospective, multi-center, single-arm study in adults and children ages 6 to 80 with type 1 diabetes to evaluate the safety of Lyumjev with Control-IQ technology to achieve labeling updates for Lyumjev and the t:slim X2 insulin pump.
Detailed Description
This is a prospective, multi-center, single-arm study in adults and children (ages 6 to 80 years) with type 1 diabetes who are current users of the t:slim X2 insulin pump with Control-IQ technology to achieve labeling updates for Lyumjev and the t:slim X2 insulin pump. After a run-in period, participants will use the study pump with Control-IQ technology 1.5 and Lyumjev insulin for a 3-month outpatient treatment period. Up to 200 participants will be enrolled so at least 160 complete the study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Type 1 Diabetes
Keywords
type 1 diabetes, Control-IQ Technology, lyumjev

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
t:slim X2 insulin pump with Control-IQ technology utilizing insulin Lyumjev®
Arm Type
Experimental
Arm Description
Current Control-IQ technology users with type 1 diabetes, age 6-80, will use the t:slim X2 insulin pump with Control-IQ technology 1.5 and Lyumjev insulin for 3-months of outpatient use.
Intervention Type
Device
Intervention Name(s)
t:slim X2 insulin pump with Control-IQ technology 1.5
Intervention Description
t:slim X2 insulin pump with Control-IQ technology 1.5, and wearing the Dexcom G6 sensor, used with Lyumjev® insulin.
Primary Outcome Measure Information:
Title
Severe hypoglycemia
Description
Number of severe hypoglycemia events (with cognitive impairment such that assistance of another individual is needed for treatment) during study compared with data on severe hypoglycemic events reported by T1D Exchange clinic registry
Time Frame
3 months
Title
Diabetic ketoacidosis
Description
Number of diabetic ketoacidosis events
Time Frame
3 months
Title
Unanticipated adverse device effects
Description
Number of unanticipated adverse device effects (UADE) events
Time Frame
3 months
Title
Other serious adverse events
Description
Number of other serious adverse events
Time Frame
3 months
Title
Adverse drug reactions
Description
Number of adverse drug reactions
Time Frame
3 months
Secondary Outcome Measure Information:
Title
All reportable adverse events
Description
Number of reportable adverse events during the course of the study
Time Frame
3 months
Title
CGM hypoglycemia outcomes: Overall % time <54 mg/dL
Description
CGM overall percent time < 54 mg/dL
Time Frame
3 months
Title
CGM hypoglycemia outcomes: Postprandial % time <54 mg/dL
Description
CGM postprandial percent time < 54 mg/dL
Time Frame
3 months
Title
CGM hypoglycemia outcomes: Overall % time <70 mg/dL
Description
CGM overall percent time < 70 mg/dL
Time Frame
3 months
Title
CGM hypoglycemia outcomes: Postprandial % time <70 mg/dL
Description
CGM postprandial percent time < 70 mg/dL
Time Frame
3 months
Title
CGM hypoglycemia outcomes: Rate of hypoglycemia events
Description
Rate of hypoglycemia events defined as 15 or more consecutive minutes <54 mg/dL
Time Frame
3 months
Other Pre-specified Outcome Measures:
Title
Postprandial incremental area under the glucose curve
Description
CGM postprandial incremental area under the glucose curve (4 hr)
Time Frame
4 hours
Title
Peak postprandial glucose
Description
Peak postprandial glucose (mg/dL)
Time Frame
4 hours
Title
Time in range - overall and postprandial 70-180 mg/dL
Description
CGM time in range 70-180 mg/dL overall and postprandial
Time Frame
3 months
Title
Time in range - overall and postprandial >180 mg/dL
Description
CGM time in range >180 mg/dL overall and postprandial
Time Frame
3 months
Title
Time in range - overall and postprandial >250 mg/dL
Description
CGM time in range >250 mg/dL overall and postprandial
Time Frame
3 months
Title
Times in range - overall and postprandial 70-140 mg/dL
Description
CGM time in range 70-140 mg/dL overall and postprandial
Time Frame
3 months
Title
Mean glucose
Description
Mean CGM glucose mg/dL
Time Frame
3 months
Title
Rate of hyperglycemia events
Description
Rate of hyperglycemia events, defined as 90 or more minutes >300 mg/dL within 120 minutes
Time Frame
3 months
Title
Overall variability (Coefficient of Variation and Standard Deviation)
Description
CGM overall variability as measured by Coefficient of Variation and Standard Deviation (mg/dL)
Time Frame
3 months
Title
HbA1c change from baseline
Description
Change in HbA1c (%) from baseline to 3 months
Time Frame
3 months
Title
CGM metrics for time in range by time of day
Description
CGM metrics for time in range for: All 24 hours of the day, Daytime only (06:00AM to 00:00AM), Nighttime only (00:00AM to 06:00AM).
Time Frame
3 months
Title
CGM metrics for time in hypoglycemia by time of day
Description
CGM metrics for time in hypoglycemia for: All 24 hours of the day, Daytime only (06:00AM to 00:00AM), Nighttime only (00:00AM to 06:00AM).
Time Frame
3 months
Title
CGM metrics for time in hyperglycemia by time of day
Description
CGM metrics for time in hyperglycemia for: All 24 hours of the day, Daytime only (06:00AM to 00:00AM), Nighttime only (00:00AM to 06:00AM).
Time Frame
3 months
Title
CGM metrics for glucose variability by time of day
Description
CGM metrics for glucose variability for: All 24 hours of the day, Daytime only (06:00AM to 00:00AM), Nighttime only (00:00AM to 06:00AM).
Time Frame
3 months
Title
Patient Reported Outcomes: TRIM-D
Description
Patient Reported Outcomes on the TRIM-D scale, comparing baseline to 3 months
Time Frame
3 months
Title
Patient Reported Outcomes: TRIM-DD
Description
Patient Reported Outcomes on the TRIM-DD scale, comparing baseline to 3 months
Time Frame
3 months
Title
Patient Reported Outcomes: ITSQ
Description
Patient Reported Outcomes on the ITSQ scale, comparing baseline to 3 months
Time Frame
3 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
6 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age 6 to <81 years Diagnosis of type 1 diabetes for at least 1 year Currently using Control-IQ technology for at least 3 months, with CGM data recorded indicative of system use (active closed loop) for at least 85% of the possible time in 14 days prior to enrollment Total daily insulin dose (TDD) at least 2 U/day HbA1c < 10.5% Residing full-time in the United States, with no anticipated travel outside the United States during the period of study participation. For participants <18 years old, living with one or more parent/legal guardian knowledgeable about emergency procedures for severe hypoglycemia and able to contact the participant in case of an emergency, and willing to use the Dexcom Follow app (with push notifications turned on) for the duration of the study. If >18 years old, participant has someone who lives within 30 minutes of them who is willing to be contacted if the study team can't reach the participant in case of a suspected medical emergency. Participant has agreed to participate in the study; and has read, understood and signed the informed consent form (ICF) and assent, if applicable; and has agreed to follow all study procedures, including: suspending use of any personal CGM for the duration of the clinical trial once the study CGM is in use switching to or continuing to use Humalog during the lead-in period switching to Lyumjev for the main study period. willing and able to perform the study exercise and meal challenges. Investigator has confidence that the participant can successfully operate all study devices and is capable of adhering to the protocol, including ability to respond to alerts and alarms, and to provide basic diabetes self-management. Participant and/or parent/legal guardian have the ability to read and understand English Exclusion Criteria: More than 1 episode of diabetic ketoacidosis (DKA) in the past 6 months More than 1 episode of severe hypoglycemia (needing assistance) in the past 6 months Inpatient psychiatric treatment in the past 6 months History of drug abuse (defined as any illicit drug use) or history of alcohol abuse prior to screening or unwillingness to agree to abstain from illicit drugs throughout the study. For Female: Currently pregnant or planning to become pregnant during the time period of study participation A negative pregnancy test will be required for all females of child-bearing potential (menarchal) Counseling on appropriate birth control options will be provided to females with child-bearing potential in the event the participant does not have an acceptable plan. Adults lacking the capacity to provide consent and/or follow study procedures in the opinion of the investigator Concurrent use of any non-insulin glucose-lowering agent, other than metformin (for example, GLP-1 agonists, Symlin, DPP-4 inhibitors, SGLT-2 inhibitors, sulfonylureas). Hemophilia or any other bleeding disorder Hemoglobinopathy History of heart, liver, lung or kidney disease determined by investigator to interfere with the study History of allergic reaction to Humalog or Lyumjev Use of glucocorticoids, beta blockers or other medications determined by investigator to interfere with study Abnormal screening electrocardiogram consistent with increased risk during exercise, such as arrhythmia, ischemia, or prolonged QTc interval (>450 ms) (Screening ECG only required for participants age > 50 years, duration of diabetes > 20 years, or history of coronary artery disease) Significant chronic kidney disease (which could impact CGM accuracy in investigator's judgment) or hemodialysis History of adrenal insufficiency History of abnormal TSH consistent with hypothyroidism or hyperthyroidism that is not appropriately treated History of gastroparesis A condition, which in the opinion of the investigator or designee, would put the participant or study at risk Participation in another pharmaceutical or device trial at the time of enrollment or anticipated for during the time period of study participation Employed by, or having immediate family members employed by Tandem Diabetes Care, Inc., Eli Lilly and Co., or TypeZero Technologies, LLC, or having a direct supervisor at place of employment who is also directly involved in conducting the clinical trial (as a study investigator, coordinator, etc.); or having a first-degree relative who is directly involved in conducting the clinical trial
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jordan Pinsker, MD
Organizational Affiliation
Tandem Diabetes Care
Official's Role
Study Director
Facility Information:
Facility Name
Children's Hospital Orange County
City
Orange
State/Province
California
ZIP/Postal Code
92868
Country
United States
Facility Name
Stanford University
City
Palo Alto
State/Province
California
ZIP/Postal Code
94304
Country
United States
Facility Name
Barbara Davis Center
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Facility Name
University of Florida
City
Gainesville
State/Province
Florida
ZIP/Postal Code
32610
Country
United States
Facility Name
University of South Florida Diabetes Center
City
Tampa
State/Province
Florida
ZIP/Postal Code
33612
Country
United States
Facility Name
Northwestern University
City
Evanston
State/Province
Illinois
ZIP/Postal Code
60208
Country
United States
Facility Name
Indiana University / Riley Hospital for Children
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Facility Name
Iowa Diabetes and Endocrinology Research Center (IDERC)
City
West Des Moines
State/Province
Iowa
ZIP/Postal Code
50265
Country
United States
Facility Name
Joslin Diabetes Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Facility Name
Children's Mercy Hospital
City
Kansas City
State/Province
Missouri
ZIP/Postal Code
64108
Country
United States
Facility Name
Icahn School of Medicine at Mt. Sinai
City
New York
State/Province
New York
ZIP/Postal Code
10029
Country
United States
Facility Name
Diabetes & Glandular Disease (DGD)
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
Facility Name
University of Virginia
City
Charlottesville
State/Province
Virginia
ZIP/Postal Code
22903
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Safety Evaluation of an Advanced Hybrid Closed Loop System Using Lyumjev With the Tandem t:Slim X2 Insulin Pump With Control-IQ Technology in Adults, Adolescents and Children With Type 1 Diabetes

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