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Feasibility Studies of Personalized Closed Loop

Primary Purpose

Type 1 Diabetes

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Cloud-based Digital Twin and Meal Prediction algorithms
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

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

Inclusion Criteria:

General Inclusion Criteria

  1. Subject is age 2-80 years at time of Visit 1. Note: See staged enrollment reference for adult and pediatric subjects in the Study Design section
  2. Subject has a clinical diagnosis of type 1 diabetes.

    1. Subjects 7 years of age and older: Diagnosed at least 1 year prior to Visit 1
    2. Subjects 2-6 years of age: Diagnosed at least 3 months prior to Visit 1

    Study-specific inclusion criteria

  3. Subject must have a minimum daily insulin requirement (Total Daily Dose) of greater than or equal to 8 units.
  4. If subject has a history of hypothyroidism, must have at least 1 documented normal thyroid-stimulating hormone (TSH) on historical labs within 12 months of Visit 1. A subject without a history of hyperthyroidism is not expected to have a TSH test
  5. Subjects and their parent(s)/guardian(s) must have Internet access , a computer system that meets the requirements for uploading the study pump and Smartphone that meets study requirements.
  6. Subject must have a companion or caregiver available at night for the duration of the study period who resides (or will live) in in the same building (or home). This requirement may be verified by subject report at screening visit.
  7. If subject has celiac disease, it has been adequately treated as determined by the investigator.
  8. Subjects and their parent(s)/guardian(s) are willing to take one of the following insulins and can financially support the use of either of the 2 insulin preparations throughout the course of the study (i.e. co-payments for insulin with insurance or able to pay full amount)

    • Humalog™* (insulin lispro injection)
    • NovoLog™* (insulin aspart)

Exclusion Criteria:

  1. Subject has a history of 1 or more episodes of severe hypoglycemia, which resulted in any the following during the last 1 year prior to Visit 1

    1. Medical assistance (i.e. Paramedics, Emergency Room (ER) or Hospitalization)
    2. Coma
    3. Seizures
  2. Subject is unable to tolerate tape adhesive in the area of sensor placement.
  3. Subject has any unresolved adverse skin condition in the area of sensor placement (e.g., psoriasis, dermatitis herpetiformis, rash, Staphylococcus infection).
  4. Women of child-bearing potential who have a positive pregnancy test at Visit 1 or plan to become pregnant during the course of the study
  5. Females who are sexually active and able to conceive will be excluded if they are not using an effective method of contraception and do not agree to continue using an effective method of contraception for the duration of the study as determined by investigator.
  6. Subject has a cardiovascular condition which the Study Investigator determines should exclude the subject, e.g. ventricular rhythm disturbance, hypertrophic cardiomyopathy, recent myocardial infarction in the last year prior to Visit 1.
  7. Subject is being treated for hyperthyroidism at time of Visit 1.
  8. Subject has a diagnosis of adrenal insufficiency.
  9. Subject has had Diabetic Ketoacidosis (DKA) within 1 year prior to Visit 1.
  10. Subject has taken any oral, injectable, or intravenous (IV) glucocorticoids within 8 weeks from time of visit 1, or plans to take any oral, injectable, or IV glucocorticoids during the course of the study.
  11. Subject is actively participating in an investigational study (e.g., drug or device) wherein he/she has received treatment from an investigational study (drug or device) in the last 2 weeks prior to Visit 1. Please note participation in observational study is acceptable.
  12. Subject has been hospitalized or has visited the ER in the 6 months prior to Visit 1 resulting in a primary diagnosis of uncontrolled diabetes.
  13. Subject is currently abusing illicit drugs.
  14. Subject is currently abusing alcohol.
  15. Subject is using pramlintide (Symlin), DPP-4 inhibitor, liraglutide (Victoza or other GLP-1 agonists), metformin, canagliflozin (Invokana or other SGLT2 inhibitors) at time of Visit 1.
  16. Subject 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.
  17. Subject has elective surgery planned that requires general anesthesia during the course of the study.
  18. Subject diagnosed with current eating disorder such as anorexia or bulimia.
  19. Subject has been diagnosed with chronic kidney disease that results in chronic anemia.
  20. Subject is on dialysis.
  21. Subject has serum creatinine of >2 mg/dL, as confirmed through historical labs within 1 year prior to Visit 1.
  22. Subject is a member the research staff involved with the study.

Sites / Locations

  • Loma Linda University Medical Center
  • Diablo Clinical Research
  • Barbara Davis Center - Adults
  • Barbara Davis Center / Pediatric
  • University of South Florida Diabetes Center
  • Atlanta Diabetes Associates
  • Endocrine Research Solutions, Inc.
  • Rocky Mountain Diabetes
  • Mayo Clinic
  • Park Nicollet International Diabetes Center
  • AM Diabetes and Endocrinology Center
  • Rainier Clinical Research

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Algorithm Testing

Arm Description

The main purpose of this cohort is to test the Digital Twin insulin delivery algorithm and the Meal Prediction algorithm The study population will be enrolled as 2 separate cohorts to test each algorithms individually

Outcomes

Primary Outcome Measures

Number of Severe Hypoglycemic Event - Cohort A
Number of severe hypoglycemic events occurred in the study in Cohort A
Number of Diabetic Ketoacidosis (DKA) Event - Cohort A
Number of Diabetic Ketoacidosis (DKA) event occurred in the study in Cohort A
Percentage of Time in Euglycemia - Cohort A
The overall mean percentage of time in Euglycemia (70-180 mg/dL) in Cohort A
Number of Severe Hypoglycemic Event - Cohort C
Number of severe hypoglycemic events occurred in the study in Cohort C
Number of Diabetic Ketoacidosis (DKA) Event - Cohort C
Number of Diabetic Ketoacidosis (DKA) event occurred in the study in Cohort C
Percentage of Time in Euglycemia - Cohort C
The overall mean percentage of time in Euglycemia (70-180 mg/dL) in Cohort C

Secondary Outcome Measures

Full Information

First Posted
December 13, 2019
Last Updated
April 12, 2023
Sponsor
Medtronic Diabetes
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1. Study Identification

Unique Protocol Identification Number
NCT04203823
Brief Title
Feasibility Studies of Personalized Closed Loop
Official Title
Feasibility Study With Personalized Closed Loop (PCL)
Study Type
Interventional

2. Study Status

Record Verification Date
April 2023
Overall Recruitment Status
Completed
Study Start Date
July 20, 2020 (Actual)
Primary Completion Date
January 27, 2022 (Actual)
Study Completion Date
January 27, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Medtronic Diabetes

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
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a single arm study comprised of a series of feasibility studies.
Detailed Description
Feasibility Study Part 2 (i.e. Feasibility 2): Feasibility 2 is the focus of the current version of the study protocol. This study will include 2 separate Cohorts of individuals, based on the algorithms being studied: Cohort A: The main purpose of this cohort is to test the Digital Twin insulin delivery algorithm adaptation Cohort C: The main purpose of this cohort is to test a meal prediction algorithm

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
Model Description
Single Arm (Cohort) assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
126 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Algorithm Testing
Arm Type
Experimental
Arm Description
The main purpose of this cohort is to test the Digital Twin insulin delivery algorithm and the Meal Prediction algorithm The study population will be enrolled as 2 separate cohorts to test each algorithms individually
Intervention Type
Device
Intervention Name(s)
Cloud-based Digital Twin and Meal Prediction algorithms
Intervention Description
Test safety and effectiveness of the Digital Twin and Meal Prediction algorithms
Primary Outcome Measure Information:
Title
Number of Severe Hypoglycemic Event - Cohort A
Description
Number of severe hypoglycemic events occurred in the study in Cohort A
Time Frame
approximately 3.5 months
Title
Number of Diabetic Ketoacidosis (DKA) Event - Cohort A
Description
Number of Diabetic Ketoacidosis (DKA) event occurred in the study in Cohort A
Time Frame
approximately 3.5 months
Title
Percentage of Time in Euglycemia - Cohort A
Description
The overall mean percentage of time in Euglycemia (70-180 mg/dL) in Cohort A
Time Frame
approximately 3.5 months
Title
Number of Severe Hypoglycemic Event - Cohort C
Description
Number of severe hypoglycemic events occurred in the study in Cohort C
Time Frame
approximately 3.5 months
Title
Number of Diabetic Ketoacidosis (DKA) Event - Cohort C
Description
Number of Diabetic Ketoacidosis (DKA) event occurred in the study in Cohort C
Time Frame
approximately 3.5 months
Title
Percentage of Time in Euglycemia - Cohort C
Description
The overall mean percentage of time in Euglycemia (70-180 mg/dL) in Cohort C
Time Frame
approximately 3.5 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
2 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: General Inclusion Criteria Subject is age 2-80 years at time of Visit 1. Note: See staged enrollment reference for adult and pediatric subjects in the Study Design section Subject has a clinical diagnosis of type 1 diabetes. Subjects 7 years of age and older: Diagnosed at least 1 year prior to Visit 1 Subjects 2-6 years of age: Diagnosed at least 3 months prior to Visit 1 Study-specific inclusion criteria Subject must have a minimum daily insulin requirement (Total Daily Dose) of greater than or equal to 8 units. If subject has a history of hypothyroidism, must have at least 1 documented normal thyroid-stimulating hormone (TSH) on historical labs within 12 months of Visit 1. A subject without a history of hyperthyroidism is not expected to have a TSH test Subjects and their parent(s)/guardian(s) must have Internet access , a computer system that meets the requirements for uploading the study pump and Smartphone that meets study requirements. Subject must have a companion or caregiver available at night for the duration of the study period who resides (or will live) in in the same building (or home). This requirement may be verified by subject report at screening visit. If subject has celiac disease, it has been adequately treated as determined by the investigator. Subjects and their parent(s)/guardian(s) are willing to take one of the following insulins and can financially support the use of either of the 2 insulin preparations throughout the course of the study (i.e. co-payments for insulin with insurance or able to pay full amount) Humalog™* (insulin lispro injection) NovoLog™* (insulin aspart) Exclusion Criteria: Subject has a history of 1 or more episodes of severe hypoglycemia, which resulted in any the following during the last 1 year prior to Visit 1 Medical assistance (i.e. Paramedics, Emergency Room (ER) or Hospitalization) Coma Seizures Subject is unable to tolerate tape adhesive in the area of sensor placement. Subject has any unresolved adverse skin condition in the area of sensor placement (e.g., psoriasis, dermatitis herpetiformis, rash, Staphylococcus infection). Women of child-bearing potential who have a positive pregnancy test at Visit 1 or plan to become pregnant during the course of the study Females who are sexually active and able to conceive will be excluded if they are not using an effective method of contraception and do not agree to continue using an effective method of contraception for the duration of the study as determined by investigator. Subject has a cardiovascular condition which the Study Investigator determines should exclude the subject, e.g. ventricular rhythm disturbance, hypertrophic cardiomyopathy, recent myocardial infarction in the last year prior to Visit 1. Subject is being treated for hyperthyroidism at time of Visit 1. Subject has a diagnosis of adrenal insufficiency. Subject has had Diabetic Ketoacidosis (DKA) within 1 year prior to Visit 1. Subject has taken any oral, injectable, or intravenous (IV) glucocorticoids within 8 weeks from time of visit 1, or plans to take any oral, injectable, or IV glucocorticoids during the course of the study. Subject is actively participating in an investigational study (e.g., drug or device) wherein he/she has received treatment from an investigational study (drug or device) in the last 2 weeks prior to Visit 1. Please note participation in observational study is acceptable. Subject has been hospitalized or has visited the ER in the 6 months prior to Visit 1 resulting in a primary diagnosis of uncontrolled diabetes. Subject is currently abusing illicit drugs. Subject is currently abusing alcohol. Subject is using pramlintide (Symlin), DPP-4 inhibitor, liraglutide (Victoza or other GLP-1 agonists), metformin, canagliflozin (Invokana or other SGLT2 inhibitors) at time of Visit 1. Subject 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. Subject has elective surgery planned that requires general anesthesia during the course of the study. Subject diagnosed with current eating disorder such as anorexia or bulimia. Subject has been diagnosed with chronic kidney disease that results in chronic anemia. Subject is on dialysis. Subject has serum creatinine of >2 mg/dL, as confirmed through historical labs within 1 year prior to Visit 1. Subject is a member the research staff involved with the study.
Facility Information:
Facility Name
Loma Linda University Medical Center
City
Loma Linda
State/Province
California
ZIP/Postal Code
92354
Country
United States
Facility Name
Diablo Clinical Research
City
Walnut Creek
State/Province
California
ZIP/Postal Code
94598
Country
United States
Facility Name
Barbara Davis Center - Adults
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Facility Name
Barbara Davis Center / Pediatric
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
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
Atlanta Diabetes Associates
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30318
Country
United States
Facility Name
Endocrine Research Solutions, Inc.
City
Roswell
State/Province
Georgia
ZIP/Postal Code
30076
Country
United States
Facility Name
Rocky Mountain Diabetes
City
Idaho Falls
State/Province
Idaho
ZIP/Postal Code
83404
Country
United States
Facility Name
Mayo Clinic
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States
Facility Name
Park Nicollet International Diabetes Center
City
Saint Louis Park
State/Province
Minnesota
ZIP/Postal Code
55416
Country
United States
Facility Name
AM Diabetes and Endocrinology Center
City
Bartlett
State/Province
Tennessee
ZIP/Postal Code
38133
Country
United States
Facility Name
Rainier Clinical Research
City
Renton
State/Province
Washington
ZIP/Postal Code
98057
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Feasibility Studies of Personalized Closed Loop

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