Exercise-Induced Hypoglycemia Prevention in Adults With Type 1 Diabetes Using an Artificial Pancreas
Type 1 Diabetes Mellitus, Hypoglycemia
About this trial
This is an interventional treatment trial for Type 1 Diabetes Mellitus focused on measuring Artificial Pancreas, Continuous Glucose Monitor, Exercise, Exercise-Induced Hypoglycemia
Eligibility Criteria
Inclusion Criteria:
- Age ≥18 and ≤65 years
- Clinical diagnosis of Type 1 Diabetes for at least one year
- Currently using an insulin pump for at least 6 months
- Uses insulin parameters such as carbohydrate ratio and correction factors consistently on their insulin pump in order to dose insulin for meals or corrections
- Access to internet and willingness to upload data during the study
- Willingness to be physically active for at least 30 minutes per day at least 4 times per week
- Willingness to perform the required exercise regimen during Data Collection Period
- Willingness to not perform regular exercise outside of the study-regimented exercise window
- For females, not currently pregnant or breastfeeding. If a female is of child-bearing potential and sexually active, she must agree to use a form of contraception to prevent pregnancy while participating in the study.
- An understanding and willingness to follow the protocol and sign informed consent.
Exclusion Criteria:
- History of diabetic ketoacidosis (DKA) in the 12 months prior to enrollment.
- Severe hypoglycemia resulting in seizure or loss of consciousness in the 12 months prior to enrollment.
- Pregnancy or intent to become pregnant during the trial.
- Currently being treated for a seizure disorder
- Coronary artery disease or heart failure, unless written clearance is received from a cardiologist or primary care provider and documentation of a negative stress test within the year
- History of cardiac arrhythmia (except for benign premature atrial contractions and benign premature ventricular contractions which are permitted)
- Clinically significant electrocardiogram (ECG) at time of Screening, as interpreted by the study medical physician.
- Use of non-insulin glucose-lowering agent (including GLP-1 agonists, pramlintide, DPP-4 inhibitors, SGLT-2 inhibitors, biguanides, sulfonylureas and naturaceuticals) with the exception of participants who have been on a stable dose of Metformin for at least 3 months.
- A known medical condition that in the judgment of the investigator might interfere with the completion of the protocol such as the following examples:
- Inpatient psychiatric treatment in the past 6 months
- Presence of a known adrenal disorder
- Abnormal liver function test results (Transaminase >2 times the upper limit of normal); testing required for subjects taking medications known to affect liver function or with diseases known to affect liver function
- Uncontrolled thyroid disease
- Use of an automated insulin delivery mechanism that is not FDA approved during the data collection phase
- Use of an automated insulin delivery mechanism that is not downloadable by the subject or study team
- Inability to be physically active for at least 30 minutes per day for at least 4 times per week
- Current enrollment in another clinical trial, unless approved by the investigators of both studies or if clinical trial is a non-interventional registry trial.
Sites / Locations
- University of Virginia
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Control - Experimental Admissions
Experimental - Control Admissions
Subjects will be randomized following the Data Collection Phase in a 1:1 ratio. Subjects in the Control-Experimental Arm will undergo the Control Admission first, utilizing an artificial pancreas (AP) controller that does not anticipate exercise (rMPC - naïve model predictive control), followed by the Experimental Admission, which will utilize an AP controller that has the ability to anticipate exercise (EnMPC - ensemble model predictive control). During the 36-hour admissions, subjects will begin using the study AP system (control or experimental) on Day 1 around midday with a scheduled exercise activity in the evening. Day 2 will consist of minimal activity and subjects will be discharged in the evening on Day 2.
Subjects will be randomized following the Data Collection Phase in a 1:1 ratio. Subjects in the Experimental-Control Arm will undergo the Experimental Admission first, utilizing an artificial pancreas (AP) controller that has the ability to anticipate exercise (EnMPC), followed by the Control Admission, which will utilize an AP controller that does not have the ability to anticipate exercise (rMPC). During the 36-hour admissions, subjects will begin using the study AP system (control or experimental) on Day 1 around midday with a scheduled exercise activity in the evening. Day 2 will consist of minimal activity and subjects will be discharged in the evening on Day 2.