Monitoring Physiologic Parameters in Individuals With Diabetic Peripheral Neuropathy

Monitoring Physiologic Parameters in Individuals With Diabetic Peripheral Neuropathy: a Prospective Study

The primary aim of this study is to use the Orpyx® SI Sensory Insole System (Orpyx Medical Technologies Inc., Calgary AB, Canada) ("Orpyx" or "the Company") as an adjunct to diabetic peripheral neuropathy standard of care (SOC), and observe step count, pressure, temperature, and adherence data through remote patient monitoring (RPM). This will provide insights into patient engagement and the benefits of offering remote, preventative care.

Study Overview

• Status: Completed
• Conditions: Diabetic Foot; Diabetic Peripheral Neuropathy
• Intervention / Treatment: Device: Orpyx SI® Sensory Insole System

• Study Type: Observational
• Enrollment (Actual): 60

Contacts and Locations

• Study Contact: Name: E Bray; Phone Number: +1 (855) 996-7799; Email: emily.bray@orpyx.com

Study Locations

• United States
  • Ohio
    • Circleville, Ohio, United States, 43113
      • WAFL Inc / Cutting Edge Research

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 100 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

The participant population to be studied will be subjects 18 years of age or older who have been diagnosed with diabetes (Type I or Type II) and neuropathy and who are at moderate to high risk of foot ulceration based on the International Working Group on the Diabetic Foot (IWDGF) guidelines.

Description

Inclusion Criteria:

• Clinically diagnosed neuropathy and type 1 or 2 diabetes
• Qualification as a "Moderate or High-Risk Participant," as defined by the International Working Group on the Diabetic Foot (IWGDF) Guidelines
• Complete healing of any previous foot ulcers, as defined by complete re-epithelialization of healed ulcer which is confirmed by two medical exams that occur at least two to three weeks apart (V0 and V1)
• Ability to walk independently (without use of wheelchair) for 30 steps
• Aged >18 years
• Ability to understand all the study and device requirements and have a life expectancy greater than the study duration
• 0.6 < [ABI] < 1.2, capillary refill time < 5 seconds (in the last 12 months)
• Subject is willing and able to wear the Orpyx Sensory Insoles and provided diabetic footwear during all weight bearing activities (sitting, standing, walking, and wearing footwear)
• Most recent HbA1c level of < 12.0% (in the last 12 months)
• Subject or caregiver is able to see the bottom of their feet and inspect for redness, callus, and wounds as per standard of care
• Subject is willing to wear the sensory insoles and carry the digital display device all day, but for a minimum of 4.5 hours a day
• Subject is willing to charge the Orpyx SI Sensory Insoles overnight every night

Exclusion Criteria:

• Active ulcer or presence of other open chronic wound (on foot or other body surface), regardless of etiology (e.g., vasculitis, neoplasms, or hematological disorders)
• Past history of known non-neuropathic foot ulcer (i.e., arterial or venous insufficiency ulcer)
• Presence of severe vascular disease (refer to acceptable ABI parameters in section 7.7.1)
• Dementia
• Psychiatric illnesses or social situations that would limit compliance with the study
• Serious underlying balance dysfunction, regardless of etiology
• Significant cardiopulmonary or other systemic disease limiting the participant's ability to walk at least 30 steps or to stand for an amount of time equal to or greater than five (5) minutes
• Current participation in another clinical investigation of a medical device or a drug; or participation in such a study within 30 days prior to this study enrolment
• Current osteomyelitis or gangrene of the lower extremity
• Uncorrected plantar Charcot neuroarthropathy
• Bunion which would predispose ulcer formation (clinician discretion)
• Extreme equinus
• Hallux valgus
• At the start of V1, the subject does not continue to meet the entrance criteria (inclusion and exclusion)
• Hallux rigidus / limitus
• Any condition that would affect or limit the ability to properly fit both shoes with the device under study
• Subject has a history of intercurrent illness or conditions that would compromise the safety of the subject or their ability to participate in this study
• Subject is in a site of care that is not conducive to ambulation or qualify for remote patient care (skilled nursing facility, acute care facility)
• Amputations on the foot which require additive insole modifications (including but not limited to transmetatarsal, toe or ray amputations which create the need for a toe filler, or which prevent the subject from wearing the prescribed footwear)

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Frequency and location of high-pressure plantar areas	frequency and location of high-pressure plantar areas	3 months

Collaborators and Investigators

• Sponsor: Orpyx Medical Technologies Inc.

Study record dates

Study Major Dates

• Study Start (Actual): April 1, 2022
• Primary Completion (Actual): April 23, 2023
• Study Completion (Actual): April 28, 2023

Study Registration Dates

• First Submitted: November 4, 2022
• First Submitted That Met QC Criteria: November 10, 2022
• First Posted (Actual): November 14, 2022

Study Record Updates

• Last Update Posted (Actual): May 9, 2023
• Last Update Submitted That Met QC Criteria: May 5, 2023
• Last Verified: May 1, 2023

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Cardiovascular Diseases; Vascular Diseases; Nervous System Diseases; Skin Diseases; Endocrine System Diseases; Diabetic Angiopathies; Leg Ulcer; Skin Ulcer; Diabetes Complications; Diabetes Mellitus; Neuromuscular Diseases; Foot Ulcer; Diabetic Foot; Peripheral Nervous System Diseases; Diabetic Neuropathies
• Other Study ID Numbers: ORPYX

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

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