The SHINE Study: Safety of Implant and Preliminary Performance of the SHINE SYSTEM in Diabetic Subjects

The SHINE Study: An Open Label, Interventional, Multicentre, Prospective Feasibility Study, Designed to Evaluate the Safety of Implant and Preliminary Performance of the SHINE SYSTEM in Diabetic Subjects

The objectives of SHINE study are to confirm the safety aspects of the SHINE SYSTEM. Moreover, the goal of this clinical investigation is the initial evaluation of sensor's performance by assessing sensor's ability to qualitatively detect the appropriate analytes in subjects with diabetes of 18 years and older.

Study Overview

• Status: Completed
• Conditions: Diabetes Mellitus, Type 2; Diabetes Mellitus; Hypoglycemia; Diabetes Mellitus, Type 1; Ketoacidosis, Diabetic; Hyperglycaemia (Diabetic)
• Intervention / Treatment: Device: The SHINE SYSTEM

Detailed Description

Indigo Diabetes N.V. is currently developing an active implantable medical device, intended to be used for real time, continuous measurement of glucose and ketone levels in the interstitial fluid in adults (18 years and older) with diabetes mellitus. Based on the outcome of the GLOW Study, Indigo developed a prototype, the SHINE SYSTEM, that will be used during the planned clinical investigation (SHINE study).The objectives of SHINE study are to confirm the safety aspects of the SHINE system. Moreover, the goal of this clinical investigation is the initial evaluation of sensor's performance by assessing sensor's ability to qualitatively detect the appropriate analytes in subjects with diabetes of 18 years and older. Clinical performance of the device will not be formally evaluated during this clinical investigation. The study is designed to enable data collection (i.e., continuous collection of data by FUSHO sensor, implanted in study subject, combined with simultaneous collection of data collected by Dexcom G6), which will be used to develop the software algorithm in a future version of the device, in order to display measurements in real-time to the user.

• Study Type: Interventional
• Enrollment (Actual): 6
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Belgium
  • Antwerp, Belgium, 2650
    • University Hospital Antwerp
• France
  • Montpellier, France
    • Lapeyronie Montpellier University Hospital
• Slovenia
  • Ljubljana, Slovenia
    • University Medical Centre

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Subjects willing to sign an informed consent form (ICF)
• Adult subjects, age ≥ 18
• Subjects willing to comply to study protocol requirements (study visits with frequent venous blood sampling and deliberate insulin, glucose, ketone and lactate (sub study only) challenges)
• Subjects willing to wear a Dexcom G6 CGM during duration of the study
• Subjects willing to charge the FUSHO SENSOR/ED and CHARGER on daily basis
• Patients with type 1 diabetes mellitus (T1DM) according to WHO criteria, diagnosed for at least 12 months prior to screening, on Multiple Daily Injections (MDI), not on insulin pump treatment during the course of the study
• Patients with type 2 diabetes mellitus (T2DM) on Intensive Insulin Therapy (IIT), with a minimum of four injections per day and known dosing parameters

Exclusion Criteria:

• Known allergy to PDMS
• Subjects with a contraindication to undergo challenging tests (i.e., ischemic heart disease, epilepsy, panhypopituitarism, hypoadrenalism, untreated hypothyroidism)
• History of severe hypoglycaemia in the previous 6 months. Severe hypoglycaemia is defined as hypoglycaemia resulting in loss of consciousness or seizure
• History of diabetic ketoacidosis requiring emergency room visit or hospitalization in the previous 6 months
• History of, hepatitis C or HIV or other disease transmissible by blood
• A condition requiring or likely to require magnetic resonance imaging (MRI) during the study duration
• Female subjects who are pregnant, planning on becoming pregnant or nursing
• Coagulation disorder, wound healing and bleeding disorder or taking anticoagulant medication (oral anticoagulants; antiplatelets (such as aspirin, ticagrelor are allowed).
• Anemia identified by a haemoglobin <14 g/dL for men or <12 g/dL for women
• The presence of any other active implanted device
• The presence of any other CGM sensor or transmitter located in lower abdomen or back (other location is acceptable)
• Waist circumference of >120 cm
• Any disorder, which in the investigator's opinion might jeopardise subject's safety or compliance with the protocol.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Device Feasibility
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: The SHINE SYSTEM	Device: The SHINE SYSTEM; The FUSHO sensor, which is part of the SHINE SYSTEM, is a continuous multi-metabolite monitoring (CMM) sensor which is a miniaturized near-infrared spectrometer that measures the absorption of light in the interstitial fluid to quantify the concentration of multiple metabolites

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Primary Safety Objectives: Confirm safe implantation of the SENSOR in human subcutaneous tissue (insertion procedural safety)	Incidence of FUSHO SENSOR insertion procedure-related serious adverse events within 30 days from implant	30 days
Primary Safety Objectives: Confirm the safety of the device during the implantation period (safety of device integration in the subcutaneous tissue)	Assessment of device related adverse events during 6 months of implant use	6 months
Primary Initial Performance Objectives: Demonstration of SENSOR stability	Demonstrate that device is able to provide a stable spectral signal and whether it is feasible to use these data points to create an algorithm. SENSOR Stability is defined by maintaining its spectral characteristics (availability, intensity and range) over its implantation duration of 6 months	6 months
Primary Initial Performance Objectives: Confirm the ability to (a) retrieve spectral and metadata from the SENSOR and upload to the CLOUD	(a) Evaluation of the Bluetooth transmission: successful transmission of the spectral data from FUSHO SENSOR to the CLOUD via Bluetooth Low Energy (BLE). The proportion of data transmitted to the CLOUD versus the expected amount of data when device used as intended	6 months
Primary Initial Performance Objectives: Confirm the ability to (b) show the battery and SENSOR-ED connectivity status to subject	(b) Display of battery and FUSHO SENSOR-ED connectivity status to subject	6 months
Primary Initial Performance Objectives: Confirm the ability to (c) recharge the SENSOR, ED and CHARGER.	(c) Charging (charging efficiency) of the FUSHO SENSOR, as recorded on the APP	6 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Secondary Safety Objectives: Confirm safe explantation of the SENSOR from human subcutaneous tissue (removal procedural safety)	Incidence of FUSHO SENSOR removal-related serious adverse events within 30 days from explant	30 days
Secondary Safety Objectives: Confirm general safety in the clinic and during home use (general safety)	All Serious Adverse Events collected throughout the study and reported at 30 days, 3 months and 6 months; Assessment of device related adverse events at 30 days, 3 and 6 months; Wound status at each visit. Final result on healing just at explant.	6 months
Secondary Performance Objective: Assessment of procedural success for the implantation procedure	Successful FUSHO implantation (first implant in case of re-implant) procedure on average performed within 20 minutes (from incision to closure) without occurrence of procedure related SAEs	30 days
Secondary Performance Objective: Assessment of procedural success for the explantation procedure	Successful FUSHO explantation procedure on average performed within 20 minutes (from incision to closure) without occurrence of procedure related SAEs	30 days
Secondary Performance Objective: Assessment of procedural success for the implantation and explantation procedure	Procedural success defined as implantation of the FUSHO SENSOR within an average of 20 minutes (from start incision to closing of skin) without the occurrence of procedure related adverse events up to 30 days after implant	30 days
Secondary Performance Objective: Assessment of procedural success for the implantation and explantation procedure	The primary initial performance endpoint at further timepoints through 30 days and 3 months	30 days

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Exploratory Analysis: Establishment of a model for evaluation of blood glucose, ketone and lactate values by the SENSOR by using the values obtained by other than SENSOR data	Development and refinement of a model that allows correct analysis of the spectral data read and translation into glucose, ketone and lactate (for sub-study only) values. The values will be analysed in conjunction with values obtained by comperative methods and used to further adjust this model. The model is expected to be able to demonstrate increased performance by subsequent iterations based on known absolute values. Iterations are expected to be performed until values are suitable for validation	6 months
Exploratory Analysis: Accuracy of measurements for glucose demonstrated by Mean Absolute Relative Difference (MARD)	Post hoc analysis of accuracy of measurements for glucose demonstrated by Mean Absolute Relative Difference (MARD) intended for evaluation of the appropriateness of the algorithm/model for prediction of glucose. No health outcomes (e.g. ability to predict glycaemic values) are evaluated.	6 months
Exploratory Analysis: Accuracy of measurements for ketones demonstrated by Mean Absolute Relative Difference (MARD)	Post hoc analysis of accuracy of measurements for glucose demonstrated by Mean Absolute Relative Difference (MARD) intended for evaluation of the appropriateness of the algorithm/model for prediction of ketones. No health outcomes (e.g. ability to predict glycaemic values) are evaluated.	6 months
Exploratory Analysis: Accuracy of measurements for lactate demonstrated by Mean Absolute Relative Difference (MARD)	Post hoc analysis of accuracy of measurements for glucose demonstrated by Mean Absolute Relative Difference (MARD) intended for evaluation of the appropriateness of the algorithm/model for prediction of lactate. No health outcomes (e.g. ability to predict glycaemic values) are evaluated.	6 months
Exploratory Analysis: Accuracy of measurements for glucose demonstrated by Mean Absolute Deviation (MAD)	Post hoc analysis of accuracy of measurements for glucose demonstrated by Mean Absolute Deviation (MAD) intended for evaluation of the appropriateness of the algorithm/model for prediction of glucose. No health outcomes (e.g. ability to predict glycaemic values) are evaluated.	6 months
Exploratory Analysis: Accuracy of measurements for ketones demonstrated by Mean Absolute Deviation (MAD)	Post hoc analysis of accuracy of measurements for glucose demonstrated by Mean Absolute Deviation (MAD) intended for evaluation of the appropriateness of the algorithm/model for prediction of ketones. No health outcomes (e.g. ability to predict glycaemic values) are evaluated.	6 months
Exploratory Analysis: Accuracy of measurements for lactate demonstrated by Mean Absolute Deviation (MAD)	Post hoc analysis of accuracy of measurements for glucose demonstrated by Mean Absolute Deviation (MAD) intended for evaluation of the appropriateness of the algorithm/model for prediction of lactate. No health outcomes (e.g. ability to predict glycaemic values) are evaluated.	6 months
Exploratory Analysis: Accuracy of measurements for glucose demonstrated by Error Grid Analysis (EGA)	Post hoc analysis of accuracy of measurements for glucose demonstrated by Error Grid Analysis (EGA) intended for evaluation of the appropriateness of the algorithm/model for prediction of glucose. No health outcomes (e.g. ability to predict glycaemic values) are evaluated.	6 months
Exploratory Analysis: Accuracy of measurements for ketones demonstrated by Error Grid Analysis (EGA)	Post hoc analysis of accuracy of measurements for glucose demonstrated by Error Grid Analysis (EGA) intended for evaluation of the appropriateness of the algorithm/model for prediction of ketones. No health outcomes (e.g. ability to predict glycaemic values) are evaluated	6 months
Exploratory Analysis: Accuracy of measurements for lactate demonstrated by Error Grid Analysis (EGA)	Post hoc analysis of accuracy of measurements for glucose demonstrated by Error Grid Analysis (EGA) intended for evaluation of the appropriateness of the algorithm/model for prediction of lactate. No health outcomes (e.g. ability to predict glycaemic values) are evaluated	6 months
Exploratory Analysis: Histopathology analysis of the biopsy	Histopathology analysis of the biopsy at explant on macroscopic and microscopic level, with Haematoxylin-Eosin (HE) staining, to assess potential changes of surrounding cells and tissue around the sensor and local tissue tolerance/interaction by investigating local tissue inflammation (fibrosis, foreign body reaction (e.g. presence of giant cells, macrophages and other))	6 months

Collaborators and Investigators

• Sponsor: Indigo Diabetes NV
• Investigators: Principal Investigator: Christophe De Block, Prof. Dr., University Hospital, Antwerp

Study record dates

Study Major Dates

• Study Start (Actual): September 21, 2022
• Primary Completion (Actual): December 19, 2023
• Study Completion (Actual): January 23, 2024

Study Registration Dates

• First Submitted: September 19, 2022
• First Submitted That Met QC Criteria: October 24, 2022
• First Posted (Actual): October 28, 2022

Study Record Updates

• Last Update Posted (Actual): March 15, 2024
• Last Update Submitted That Met QC Criteria: March 14, 2024
• Last Verified: March 1, 2024

More Information

Terms related to this study

• Keywords: Hypoglycemia; Diabetes Mellitus; Hyperglycemia; Diabetes Mellitus, Type 2; Diabetes Mellitus, Type 1; Ketoacidosis; GCM
• Additional Relevant MeSH Terms: Glucose Metabolism Disorders; Metabolic Diseases; Immune System Diseases; Autoimmune Diseases; Endocrine System Diseases; Diabetes Complications; Acid-Base Imbalance; Acidosis; Hyperglycemia; Diabetes Mellitus; Diabetes Mellitus, Type 2; Diabetes Mellitus, Type 1; Hypoglycemia; Ketosis; Diabetic Ketoacidosis
• Other Study ID Numbers: IND008

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No