- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05199714
A Fully-closed Loop, Pramlintide and Insulin, Artificial Pancreas Clinical Trial for Adults With Type 1 Diabetes (FCL)
A Randomized, Controlled, Crossover Pilot Trial to Assess a Fully Automated, Dual-hormone (Insulin-and-pramlintide) Artificial Pancreas Without Carbohydrate Counting in Regulating Glucose Levels in Adults With Type 1 Diabetes
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The aim of this pilot study is to generate additional data of (i) a Fiasp-alone artificial pancreas with carbohydrate-matched boluses, compared to (ii) a Fiasp-plus-Pramlintide fully automated artificial pancreas with no meal announcement in an outpatient free-living setting. The study is not powered, nor aims to answer a scientific hypothesis related to the efficacy of the pramlintide and insulin closed-loop systems.
Design
The investigators will undertake a randomized crossover study to compare the following strategies:
- Insulin-alone artificial pancreas with carbohydrate-matched boluses
- Fiasp and pramlintide artificial pancreas with no meal announcement. Ratio of 1 unit of insulin for 8μg of pramlintide.
Fiasp and pramlintide artificial pancreas with no meal announcement. Ratio of 1 unit of insulin for 10μg of pramlintide.
Each participant will be offered the opportunity to further participate in two optional additional arms:
- Aspart and pramlintide artificial pancreas with no meal announcement. Ratio of 1 unit of insulin for 8μg of pramlintide.
- Aspart and pramlintide artificial pancreas with no meal announcement. Ratio of 1 unit of insulin for 10μg of pramlintide.
Aspart is used in this optional arm as it is the slower-acting version of Fiasp and can therefore be used to draw reasonable comparisons. Further, Aspart is an FDA approved insulin which is commonly sold and prescribed in North America. Several co-formulations are being developed with insulin, pramlintide, and glucagon. Given the widespread adoption and use of Aspart, it makes this insulin a good candidate for use in co-formulations and an excellent option for transition to market, where they will impact many individuals living with diabetes.
Treatment period: Each intervention will last 14 hours. At-home run-ins, lasting two to four days, will occur prior to the pramlintide interventions. The interventions containing pramlintide with the same insulin will occur in sequence, one immediately after the other. The first pramlintide-and-Fiasp intervention will use a ratio of 8μg pramlintide/1unit of insulin and will be followed by the second pramlintide-and-Fiasp intervention the next day with a 10μg/1unit ratio. A similar schedule will be applied to the optional Aspart-and-pramlintide interventions. There will be a 2-29-day washout period between the Fiasp-and-pramlintide, Fiasp-alone, and Aspart-and-pramlintide interventions. Participants will be followed up remotely 1-2 days after the end of each intervention to ensure their washout period is going smoothly and will inquire about any adverse events. Remote contact can be performed via phone, email, text message or other reasonable communication channel. Participants will also be followed up remotely 1-2 days and 1-2 weeks after the end of their participation in the study.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Madison Odabassian, BSc.
- Phone Number: 5142179519
- Email: Madison.odabassian@mail.mcgill.ca
Study Locations
-
-
Quebec
-
Montreal, Quebec, Canada, H4A 3T2
- Research Institute of the McGill University Health Center
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Females and males ≥ 18 years of age.
- Clinical diagnosis of type 1 diabetes for at least 12 months. The diagnosis of type 1 diabetes is based on the investigator's judgment; C peptide level and antibody determinations are not needed.
- Use of insulin pump therapy for at least 3 months.
- Effective birth-control use in individuals of childbearing potential. Individuals of child-bearing potential must agree to use a highly effective method of birth control.
Exclusion Criteria:
- Current or ≤ 1 month use of other antihyperglycemic agents (SGLT2I (sodium-glucose transporter), GLP-1(glucagon-like peptide), Metformin, etc.).
- Current use of glucocorticoid medication (except low, stable does and inhaled steroids).
- Individuals with confirmed gastroparesis.
- Use of medication that alters gastrointestinal motility.
- Planned or ongoing pregnancy.
- Breastfeeding individuals.
- Severe hypoglycemia requiring hospitalization in the past three months.
- Severe diabetic ketoacidosis episode in the past three months.
- Clinically significant nephropathy, neuropathy or retinopathy as judged by the investigator.
- Recent (< 6 months) acute macrovascular event e.g., acute coronary syndrome or cardiac surgery.
- Other serious medical illness likely to interfere with study participation or with the ability to complete the trial by the judgment of the investigator.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Fiasp-and-pramlintide fully automated system (8μg)
Fiasp and pramlintide artificial pancreas with no meal announcement.
Ratio of 1 unit of insulin for 8μg of pramlintide.
|
Fiasp Insulin delivered in a basal-bolus manner.
Medtronic insulin pump, Dexcom G6 continuous glucose sensor, tablet running the Artificial Pancreas Algorithm.
Pramlintide delivered in a basal-bolus manner.
|
Active Comparator: Fiasp-alone with carbohydrate-matched boluses
The Fiasp-alone intervention will have a 14 hour duration.
During which, carbohydrate counting will inform insulin bolus doses based on insulin to carbohydrate ratios.
|
Fiasp Insulin delivered in a basal-bolus manner.
|
Experimental: Aspart-and-pramlintide fully automated system (10μg)
Aspart and pramlintide artificial pancreas with no meal announcement.
Ratio of 1 unit of insulin for 10μg of pramlintide.
|
Medtronic insulin pump, Dexcom G6 continuous glucose sensor, tablet running the Artificial Pancreas Algorithm.
Pramlintide delivered in a basal-bolus manner.
Aspart insulin delivered in a basal-bolus manner.
|
Experimental: Fiasp-and-pramlintide fully automated system (10μg)
Fiasp and pramlintide artificial pancreas with no meal announcement.
Ratio of 1 unit of insulin for 10μg of pramlintide.
|
Fiasp Insulin delivered in a basal-bolus manner.
Medtronic insulin pump, Dexcom G6 continuous glucose sensor, tablet running the Artificial Pancreas Algorithm.
Pramlintide delivered in a basal-bolus manner.
|
Experimental: Aspart-and-pramlintide fully automated system (8μg)
Aspart and pramlintide artificial pancreas with no meal announcement.
Ratio of 1 unit of insulin for 8μg of pramlintide.
|
Medtronic insulin pump, Dexcom G6 continuous glucose sensor, tablet running the Artificial Pancreas Algorithm.
Pramlintide delivered in a basal-bolus manner.
Aspart insulin delivered in a basal-bolus manner.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Each participant's percentage of time glucose levels spent in the target range
Time Frame: 42 +/- 28 hours
|
Time in target range (3.9-10.0
mmol/L).
|
42 +/- 28 hours
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Each participant's percentage of time of glucose levels spent between 3.9 and 7.8 mmol/L
Time Frame: 42 +/- 28 hours
|
Glucose data will be collected from a glucose sensor and numerical glucose data will be analyzed as a function of time
|
42 +/- 28 hours
|
Each participant's percentage of time of glucose levels spent below 3.9 mmol/L
Time Frame: 42 +/- 28 hours
|
Glucose data will be collected from a glucose sensor and numerical glucose data will be analyzed as a function of time
|
42 +/- 28 hours
|
Each participant's percentage of time of glucose levels spent below 3.0 mmol/L
Time Frame: 42 +/- 28 hours
|
Glucose data will be collected from a glucose sensor and numerical glucose data will be analyzed as a function of time
|
42 +/- 28 hours
|
Each participant's percentage of time of glucose levels spent above 10.0 mmol/L
Time Frame: 42 +/- 28 hours
|
Glucose data will be collected from a glucose sensor and numerical glucose data will be analyzed as a function of time
|
42 +/- 28 hours
|
Each participant's percentage of time of glucose levels spent above 13.9 mmol/L
Time Frame: 42 +/- 28 hours
|
Glucose data will be collected from a glucose sensor and numerical glucose data will be analyzed as a function of time
|
42 +/- 28 hours
|
Each participant's percentage of time of glucose levels spent above 16.7 mmol/L
Time Frame: 42 +/- 28 hours
|
Glucose data will be collected from a glucose sensor and numerical glucose data will be analyzed as a function of time
|
42 +/- 28 hours
|
Each participant's mean glucose levels
Time Frame: 42 +/- 28 hours
|
42 +/- 28 hours
|
|
Each participant's standard deviation of glucose levels
Time Frame: 42 +/- 28 hours
|
42 +/- 28 hours
|
|
Each participant's coefficient of variance of glucose levels
Time Frame: 42 +/- 28 hours
|
42 +/- 28 hours
|
|
Total pramlintide delivery for each participant
Time Frame: 28 +/- 28 hours
|
28 +/- 28 hours
|
|
Total insulin delivery for each participant
Time Frame: 42 +/- 28 hours
|
42 +/- 28 hours
|
|
Total basal insulin delivery for each participant
Time Frame: 42 +/- 28 hours
|
42 +/- 28 hours
|
|
Total bolus insulin delivery for each participant
Time Frame: 42 +/- 28 hours
|
42 +/- 28 hours
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Safety Endpoints
Time Frame: 42 +/- 28 hours
|
Adverse events including gastrointestinal symptoms (nausea, vomiting, diarrhea, bloating)
|
42 +/- 28 hours
|
Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Michael Tsoukas, M.D., McGill University Health Centre/Research Institute of the McGill University Health Centre
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2022-8225
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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