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Feasibility Study Using Zone-MPC Controller (Zone-Model Predictive Control) and Health Monitoring System (HMS)

Primary Purpose

Type 1 Diabetes Mellitus

Status
Completed
Phase
Early Phase 1
Locations
United States
Study Type
Interventional
Intervention
Sansum Closed-Loop Artificial Pancreas
Insulin infusion pump
Continuous Glucose Monitor
zone-Model Predictive Control algorithm
Safety Health Monitoring System
Sponsored by
Sansum Diabetes Research Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional device feasibility trial for Type 1 Diabetes Mellitus focused on measuring type 1 diabetes mellitus, closed-loop artificial pancreas

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Clinical diagnosis of type 1 diabetes for at least one year and using an insulin pump for at least 6 months with commercially available rapid actin insulin
  • The diagnosis of type 1 diabetes is based on the investigator's judgment; C peptide level and antibody determinations are not needed.
  • Age 21 to 65 years
  • For females, not currently known to be pregnant or nursing
  • HbA1c between 5.0% and 10%, as measured with DCA2000 or equivalent device
  • Willing to perform the calibration of the study CGMs using a finger stick only and willing to follow instructions for insulin pump and CGM wear.
  • Willing to use the study CGM and study insulin pump during closed-loop.
  • Able to and agrees to avoid the following medication starting 24 hours before sensor wear through completion of CRC visit: acetaminophen, prednisone, and pseudoephedrine.
  • An understanding of and willingness to follow the protocol and sign the informed consent

Exclusion Criteria:

  • Pregnancy (as determined by a positive blood pregnancy test performed in females of childbearing capacity during screening visit and urine test at time of admission for in-patient visit) or nursing mother.
  • Diabetic ketoacidosis in the past 6 months prior to enrollment requiring emergency room visit or hospitalization
  • Severe hypoglycemia resulting in seizure or loss of consciousness in the 12 months prior to enrollment
  • Current treatment for a seizure disorder; Subjects with a history of seizures may be included in the study if they receive written clearance from their neurologist
  • Cystic fibrosis
  • Active infection
  • A known medical condition that in the judgment of the investigator might interfere with the completion of the protocol such as cognitive deficit.
  • Mental incapacity, unwillingness or language barriers precluding adequate understanding or co-operation, including subjects not able to read or write.
  • Inpatient psychiatric treatment in the past 6 months for either the subject or the subject's primary care giver (i.e., parent or guardian)
  • Coronary artery disease or heart failure. Subjects with a history of coronary artery disease may be included in the study if they receive written clearance from their cardiologist
  • Presence of a known adrenal disorder
  • Active coronary artery disease or heart failure
  • Active gastroparesis
  • If on antihypertensive, thyroid, anti-depressant or lipid lowering medication, lack of stability on the medication for the past 2 months prior to enrollment in the study
  • Uncontrolled thyroid disease. Adequately treated thyroid disease and celiac disease do not exclude subjects from enrollment
  • Abuse of alcohol
  • A recent injury to body or limb, muscular disorder, use of any medication, any carcinogenic disease, or other significant medical disorder if that injury, medication or disease in the judgment of the investigator will affect the completion of the exercise protocol
  • Current use of a beta blocker medication
  • Laboratory results:

    • Hematocrit < 30% or >55%
    • A1C > 10%
    • Abnormal liver or renal function (Transaminase > 2 times the upper limit of normal, Creatinine> 1.5 mg/dL)
    • Labs drawn at screening visit or within one month prior to screening (for other purposes) will suffice for enrollment purposes related to hematocrit
  • Subject has skin conditions that, in the determination of the investigator, would preclude wearing the study devices (infusion set and sensor), in the abdomen. Examples include but are not limited to: psoriasis, burns, scaring, eczema, tattoos, and significant hypertrophy at sites of device wear; any known allergy to medical adhesives.
  • Current participation in another investigational trial or has previously participated to this study.

Sites / Locations

  • Sansum Diabetes Research Institute

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Closed-loop session

Arm Description

The study consists of an evaluation of the Sansum Closed-loop Artificial Pancreas Device, insulin infusion pump, Continuous Glucose Monitor, zone-Model Predictive Control algorithm, and a Safety Health Monitoring System. during a 24-hour closed-loop in a clinic environment (Sansum Diabetes Research Institute, Santa Barbara, CA).

Outcomes

Primary Outcome Measures

% of time within zone [80-140] mg/dL except 5 hours post-prandial and during exercise and 3 hours post-exercise
Measures ability of AP device to maintain glucose level within a safe zone and to return to save zone following unannounced meals and exercises.

Secondary Outcome Measures

% of time within zone [80-140] mg/dL during night between 12:00 am and 7:00 am
Measures ability of AP device to maintain glucose level with a safe zone during the night and prevent hypoglycemia
% of time within zone [70-180] mg/dL 5 hours after unannounced evening meal, and breakfast
Measures ability of AP device to react to small meal and to prevent glucose level from dangerous excursions.
% of time within zone [70-150] mg/dL during the 30 min exercise
Measures ability of AP device to maintain safe glucose level during 30 minutes of non-strenuous exercise
% of time within zone [70-150] mg/dL during the 3 hours following exercise
Measures ability of AP device to address exercise and to prevent glucose level from dangerous excursions

Full Information

First Posted
October 27, 2011
Last Updated
September 7, 2021
Sponsor
Sansum Diabetes Research Institute
Collaborators
University of California, Santa Barbara
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1. Study Identification

Unique Protocol Identification Number
NCT01472406
Brief Title
Feasibility Study Using Zone-MPC Controller (Zone-Model Predictive Control) and Health Monitoring System (HMS)
Official Title
Artificial Pancreas Device Feasibility Study for Type 1 Diabetes Patients Using Model-predictive Control and Health Monitoring System Algorithms With an Approved Subcutaneous Insulin Delivery Pump and Subcutaneous Continuous Glucose Monitor
Study Type
Interventional

2. Study Status

Record Verification Date
September 2021
Overall Recruitment Status
Completed
Study Start Date
November 2011 (Actual)
Primary Completion Date
March 2014 (Actual)
Study Completion Date
March 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Sansum Diabetes Research Institute
Collaborators
University of California, Santa Barbara

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This clinical trial is a feasibility study to assess the performance of an Artificial Pancreas (AP) device using the Artificial Pancreas System (APS©) platform for subjects with type 1 diabetes. The device is a closed-loop between a DexCom™ SEVEN® PLUS (DexCom™ Corp, San Diego, CA) continuous glucose monitor (CGM) and a OneTouch® Ping® Glucose Monitoring System (Animas Corp, Westchester, PA) subcutaneous insulin delivery pump (CSII). The AP device is controlled by a zone-Model Predictive Control (zone-MPC) algorithm augmented by a safety algorithm named the Health Monitoring System (HMS). The clinical study will include 12 to 20 adults subjects aged 21 to 65 years old.
Detailed Description
The study consists of an evaluation of the Artificial Pancreas device during a 24-hour closed-loop in a clinic environment (Sansum Diabetes Research Institute, Santa Barbara, CA). The 24-hour period includes: 2 unannounced meals (evening dinner and breakfast); 1 period of 30 minutes of exercise at 50% of the predicted heart rate reserve (HRR) preceded with a snack and followed by a snack 3 hours later (on Day 2); complete night from 12:00 am to 7:00 am; The subject will arrive at approximately 4:00 pm to the CRC (clinical research center), the closed-loop will be initiated at approximately 4:30 pm that same day and continued until 4:30 pm the next day. A physician will be monitoring the patient with the artificial Pancreas (AP) device at all time. The proposed study will evaluate the performance of the AP device in predicting the fall and rise of glucose values and in regulating insulin delivery to mitigate extreme blood glucose variations during the following challenges: following unannounced meals, during a nocturnal period, and during a period of active exercise. The goal is to demonstrate that the AP device is able to maintain the subject blood glucose within a safe range at all times. One of the objectives of the study will be to measure the percent of time spent in the following zones: [80-140] mg/dL at all times unless described otherwise [80-140] mg/dL during the nocturnal period [70-180] mg/dL postprandial, for 5 hours following the unannounced meals [70-150] mg/dL during and for 3 hours following exercise It is anticipated that following the planned challenges, glucose value might increase temporarily beyond those ranges. These excursions will be reviewed and analyzed (value and duration) and the study will determine how the AP device mitigates those excursions and maintains glucose levels within a safe and acceptable range. The clinical study will also review any event that occur during the course of the 24-hour closed-loop: hypoglycemic events, hyperglycemic events, outside intervention, other Adverse Event, Serious Adverse Events, Unanticipated Adverse Device Effect, and device complaints for the commercial devices used. The safety of the patient will remain the primary goal. The goal of the AP device is to operate without outside intervention even when challenged by meals or exercise unless the outside intervention is requested by the Health Monitoring System (HMS).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Type 1 Diabetes Mellitus
Keywords
type 1 diabetes mellitus, closed-loop artificial pancreas

7. Study Design

Primary Purpose
Device Feasibility
Study Phase
Early Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
12 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Closed-loop session
Arm Type
Experimental
Arm Description
The study consists of an evaluation of the Sansum Closed-loop Artificial Pancreas Device, insulin infusion pump, Continuous Glucose Monitor, zone-Model Predictive Control algorithm, and a Safety Health Monitoring System. during a 24-hour closed-loop in a clinic environment (Sansum Diabetes Research Institute, Santa Barbara, CA).
Intervention Type
Device
Intervention Name(s)
Sansum Closed-Loop Artificial Pancreas
Other Intervention Name(s)
Sansum AP
Intervention Description
The Sansum Closed-loop Artificial Pancreas Device is the infrastructure that allows communication between the insulin pump, the CGM, the zone-MPC, and the HMS.
Intervention Type
Device
Intervention Name(s)
Insulin infusion pump
Intervention Description
The insulin pump, which has received 510k clearance (K080639), delivers insulin subcutaneously through an infusion set.
Intervention Type
Device
Intervention Name(s)
Continuous Glucose Monitor
Other Intervention Name(s)
CGM
Intervention Description
The CGM, which is an approved device (P050012), measures interstitial glucose.
Intervention Type
Device
Intervention Name(s)
zone-Model Predictive Control algorithm
Other Intervention Name(s)
zone-MPC
Intervention Description
The zone-MPC predicts future glucose values, based on CGM data, to regulate blood glucose level by increasing, decreasing, or stopping insulin infusion via an insulin infusion pump.
Intervention Type
Device
Intervention Name(s)
Safety Health Monitoring System
Other Intervention Name(s)
HMS
Intervention Description
The HMS predicts future glucose values, based on CGM data, to warn the Sansum Closed-loop Artificial Pancreas Device of values below 70 mg/dL.
Primary Outcome Measure Information:
Title
% of time within zone [80-140] mg/dL except 5 hours post-prandial and during exercise and 3 hours post-exercise
Description
Measures ability of AP device to maintain glucose level within a safe zone and to return to save zone following unannounced meals and exercises.
Time Frame
24 hours
Secondary Outcome Measure Information:
Title
% of time within zone [80-140] mg/dL during night between 12:00 am and 7:00 am
Description
Measures ability of AP device to maintain glucose level with a safe zone during the night and prevent hypoglycemia
Time Frame
24 hours
Title
% of time within zone [70-180] mg/dL 5 hours after unannounced evening meal, and breakfast
Description
Measures ability of AP device to react to small meal and to prevent glucose level from dangerous excursions.
Time Frame
24 hours
Title
% of time within zone [70-150] mg/dL during the 30 min exercise
Description
Measures ability of AP device to maintain safe glucose level during 30 minutes of non-strenuous exercise
Time Frame
24 hours
Title
% of time within zone [70-150] mg/dL during the 3 hours following exercise
Description
Measures ability of AP device to address exercise and to prevent glucose level from dangerous excursions
Time Frame
24 hours

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Clinical diagnosis of type 1 diabetes for at least one year and using an insulin pump for at least 6 months with commercially available rapid actin insulin The diagnosis of type 1 diabetes is based on the investigator's judgment; C peptide level and antibody determinations are not needed. Age 21 to 65 years For females, not currently known to be pregnant or nursing HbA1c between 5.0% and 10%, as measured with DCA2000 or equivalent device Willing to perform the calibration of the study CGMs using a finger stick only and willing to follow instructions for insulin pump and CGM wear. Willing to use the study CGM and study insulin pump during closed-loop. Able to and agrees to avoid the following medication starting 24 hours before sensor wear through completion of CRC visit: acetaminophen, prednisone, and pseudoephedrine. An understanding of and willingness to follow the protocol and sign the informed consent Exclusion Criteria: Pregnancy (as determined by a positive blood pregnancy test performed in females of childbearing capacity during screening visit and urine test at time of admission for in-patient visit) or nursing mother. Diabetic ketoacidosis in the past 6 months prior to enrollment requiring emergency room visit or hospitalization Severe hypoglycemia resulting in seizure or loss of consciousness in the 12 months prior to enrollment Current treatment for a seizure disorder; Subjects with a history of seizures may be included in the study if they receive written clearance from their neurologist Cystic fibrosis Active infection A known medical condition that in the judgment of the investigator might interfere with the completion of the protocol such as cognitive deficit. Mental incapacity, unwillingness or language barriers precluding adequate understanding or co-operation, including subjects not able to read or write. Inpatient psychiatric treatment in the past 6 months for either the subject or the subject's primary care giver (i.e., parent or guardian) Coronary artery disease or heart failure. Subjects with a history of coronary artery disease may be included in the study if they receive written clearance from their cardiologist Presence of a known adrenal disorder Active coronary artery disease or heart failure Active gastroparesis If on antihypertensive, thyroid, anti-depressant or lipid lowering medication, lack of stability on the medication for the past 2 months prior to enrollment in the study Uncontrolled thyroid disease. Adequately treated thyroid disease and celiac disease do not exclude subjects from enrollment Abuse of alcohol A recent injury to body or limb, muscular disorder, use of any medication, any carcinogenic disease, or other significant medical disorder if that injury, medication or disease in the judgment of the investigator will affect the completion of the exercise protocol Current use of a beta blocker medication Laboratory results: Hematocrit < 30% or >55% A1C > 10% Abnormal liver or renal function (Transaminase > 2 times the upper limit of normal, Creatinine> 1.5 mg/dL) Labs drawn at screening visit or within one month prior to screening (for other purposes) will suffice for enrollment purposes related to hematocrit Subject has skin conditions that, in the determination of the investigator, would preclude wearing the study devices (infusion set and sensor), in the abdomen. Examples include but are not limited to: psoriasis, burns, scaring, eczema, tattoos, and significant hypertrophy at sites of device wear; any known allergy to medical adhesives. Current participation in another investigational trial or has previously participated to this study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Howard Zisser, MD
Organizational Affiliation
Sansum Diabetes Research Institute
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Francis J Doyle, PhD
Organizational Affiliation
University of California, Santa Barbara
Official's Role
Study Director
Facility Information:
Facility Name
Sansum Diabetes Research Institute
City
Santa Barbara
State/Province
California
ZIP/Postal Code
93105
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
24471561
Citation
Harvey RA, Dassau E, Bevier WC, Seborg DE, Jovanovic L, Doyle FJ 3rd, Zisser HC. Clinical evaluation of an automated artificial pancreas using zone-model predictive control and health monitoring system. Diabetes Technol Ther. 2014 Jun;16(6):348-57. doi: 10.1089/dia.2013.0231. Epub 2014 Jan 28.
Results Reference
derived

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Feasibility Study Using Zone-MPC Controller (Zone-Model Predictive Control) and Health Monitoring System (HMS)

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