Closed Loop and Education for Hypoglycemia Awareness Restoration (CLEAR)

March 24, 2024 updated by: Vernon Michael Chinchilli, Milton S. Hershey Medical Center

Closed Loop and Education for Hypoglycemia Awareness Restoration (CLEAR), Conducted by the Impaired Awareness of Hypoglycemia Consortium (IAHC)

The purpose of the CLEAR study is to determine the effect on counterregulatory responses (CRR) of intervening (by attempting to strictly avoid hypoglycemia) to improve awareness of hypoglycemic symptoms among adults with type 1 diabetes (T1D) who have impaired awareness of hypoglycemia (IAH). IAH affects 20-25% of adults with T1D, and rises with increasing duration of T1D.

Study Overview

Detailed Description

Individuals with IAH exhibit blunted symptomatic and CR hormonal responses to hypoglycemia and, as such, have an impaired ability to respond to hypoglycemia. Thus, rates of severe hypoglycemia are up to 6-fold greater in those affected. Intensive management of T1D is necessary in preventing long-term complications, but can be complicated by recurrent episodes of hypoglycemia which lead to and sustain the CRR deficits of IAH. Technologies such as continuous glucose monitoring (CGM) and hybrid closed-loop (HCL) systems can reduce severe hypoglycemia (and also may reduce IAH) but the ability of technology to reverse impaired CRR (as assessed with experimental hypoglycemia clamp) remains unclear. Behavioral and psycho-educational interventions targeting knowledge/skills gaps, as well as particular cognitions and behaviors driving recurrent hypoglycemia, can also reduce severe hypoglycemia and improve awareness. No studies have compared technology with such behavioral interventions in terms of assessing their impact on IAH or the CRR (as a primary outcome). Unanswered questions include the degree of reduction in hypoglycemia required to restore awareness. Furthermore, participants may respond to different interventions according to their characteristics. For example, it remains unclear whether older individuals benefit from such interventions since they usually are excluded from studies. Therefore, there is an urgent need to determine effective interventions that can reverse IAH in a large representative population of adults with T1D and IAH. The investigators propose to study the effect of specific interventions aimed at restoring

  • the CRR (tested via an experimental hypoglycemia clamp procedure)
  • hypoglycemia awareness (self-reported via the Towler Questionnaire during the experimental hypoglycemia clamp procedure)

The study will use a Sequential Multiple Assignment Randomized Trial (SMART) design. At baseline, all participants who are HCL naïve will be randomized to HCL or Usual Care (UC) plus brief education (My HypoCOMPaSS) with a follow-up of two years. UC will consist of real-time continuous glucose monitoring (CGM) and insulin delivery via pump or multiple daily injections. Participants who fail to increase their CRR at 12 months will be randomized, or assigned, to a second intervention consisting of a small-group educational program focusing on motivations and unhelpful cognitions acting as barriers to hypoglycemia avoidance (HARPdoc). At baseline, all participants who are HCL non-naïve will be randomized to optimized HCL or HCL plus My HypoCOMPaSS; those with non-responsive CRR at 12 months will be randomized to either continue HCL (on the basis they need a longer period to reverse impaired CRR and total symptomatic responses) or to the HARPdoc intervention. Participants randomized to an HCL device are expected to wear the device continually, as well as a CGM. The My HypoCOMPaSS education requires 4-5 hours of training, whereas, the HARPdoc education requires four training sessions of seven hours each during weeks 1,2,3, and 6.

The specific aims and hypotheses are as follows:

Aim 1: To determine the effect on CRR (epinephrine increase ≥ 125 pg/ml over baseline) and total symptom responses (Towler Questionnaire increase ≥ 20% over baseline) during a hyperinsulinemic-hypoglycemic clamp procedure (glucose < 50 mg/dl) after 12 months of HCL versus Usual Care plus My HypoCOMPaSS Educational Intervention among adults with T1D and IAH who have never used HCL therapy previously.

Hypothesis 1: At 12 months, those allocated to Usual Care plus My HypoCOMPaSS will be more likely to have improved CRR and total symptomatic responses than those allocated to HCL.

Aim 2: To determine the effect on CRR and total symptom responses at 12 months of HCL plus My HypoCOMPaSS versus HCL alone among adults with T1D and IAH who are currently using HCL therapy prior to entering the study.

Hypothesis 2: At 12 months, those allocated to HCL plus My HypoCOMPaSS will be more likely to have improved hypoglycemic awareness and improved CRR than those using HCL alone.

Aim 3: To determine the durability of effect over 24 months of the intervention that improves CRR at 12 months among adults with type 1 diabetes and IAH at baseline.

Hypothesis 3: At 24 months, CRR will improve further among those who had restored CRR at 12 months.

Aim 4. To determine the effect on hypoglycemic awareness (Towler Questionnaire increase ≥ 20% over baseline) and CRR (epinephrine increase ≥ 125 pg/ml over baseline) during a hyperinsulinemic hypoglycemic clamp procedure at 24 months of an in-depth educational program (HARPdoc), initiated throughout months 12-24, among adults with T1D and IAH at baseline, for whom the intervention allocated at baseline did not restore CRR at 12 months.

Hypothesis 4: At 24 months, those allocated to HARPdoc for months 12-24 months will be more likely to have improved hypoglycemic awareness and CRR than those who continue with the therapy allocated at baseline.

Study Type

Interventional

Enrollment (Estimated)

324

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

    • Victoria
      • Fitzroy, Victoria, Australia, 3065
      • Leicester, United Kingdom, LE5 4PW
        • University of Leicester
        • Contact:
        • Principal Investigator:
          • Pratik Choudhary, MBBS
      • Sheffield, United Kingdom, S10 2RX
        • University of Sheffield
        • Contact:
        • Principal Investigator:
          • Simon Heller, MD
    • California
      • La Jolla, California, United States, 92037
        • University of California, San Diego
        • Contact:
        • Principal Investigator:
          • Jeremy H Pettus, MD
    • Florida
      • Orlando, Florida, United States, 32804
        • AdventHealth
        • Principal Investigator:
          • Richard E Pratley, MD
        • Principal Investigator:
          • Anna Casu, MD
        • Contact:
    • Kentucky
      • Lexington, Kentucky, United States, 40508
        • University of Kentucky
        • Contact:
        • Principal Investigator:
          • Simon Fisher, MD, PhD
    • Minnesota
      • Minneapolis, Minnesota, United States, 55455
        • University of Minnesota
    • Pennsylvania
      • Philadelphia, Pennsylvania, United States, 19104
        • University of Pennsylvania
        • Contact:
        • Principal Investigator:
          • Michael R Rickels, MD, MS

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Clinical diagnosis of type 1 diabetes
  • Gold Score or Clarke Score ≥ 4 (highly associated with IAH)
  • Random non-fasting C-peptide < 200 pmol/L
  • Diabetes duration ≥ 10 years
  • HbA1c < 10.5%
  • Total Daily Insulin Dose of < 1 unit/kg
  • Ability to read and speak English (because validated non-English versions of the cognitive tests and the educational interventions are not available)

Exclusion Criteria:

  • Medical conditions that limit participation in study activities, as determined by the PI (including but not limited to cognitive dysfunction, reduced hearing, reduced vision, cancer under active treatment, untreated angina, organ failure)
  • Active alcohol or drug abuse (as defined by DSM criteria of either 1) recurrent use of alcohol/drugs resulting in a failure to fulfill major role obligations at work, school, or home, 2) recurrent alcohol/drug use in situations in which it is physically hazardous, or 3) recurrent alcohol or drug-related legal problems)
  • Social determinants of health that limit participation in study activities, as determined by the PI (including but not limited to homelessness, food insecurity, inadequate social support)
  • Seizure disorder unrelated to hypoglycemia associated seizures, unless documented seizure-free for >12 months and on a stable regimen of anti-convulsant therapy
  • Skin conditions that would preclude the use of a CGM
  • Super-physiologic exposure to steroids within one month of enrollment
  • eGFR < 45 mL/min/1.73 m2
  • History of bariatric surgery that irreversibly alters gut innervation and structure
  • Hyper- or hypokalemia (serum potassium >5.5 or <3.5 mmol/L)*
  • Hemoglobin < 10 g/dL*
  • Medical condition that requires intermittent or continuous use of glucocorticoids at greater than physiological replacement doses
  • Pregnancy, plan for pregnancy, or breast feeding
  • Abnormal thyroid function tests of clinical significance, as determined by PI*
  • Liver transaminases > 3 times the upper limit of normal*
  • Hospitalization for mental illness in last year
  • History of adrenalectomy

    • At discretion of the PI, laboratory tests may be repeated once. If the participant is not eligible after the second attempt, then the participant. The participant may be screened again.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Sequential Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: current HCL non-user: HCL x 24 months
Hybrid closed loop device over a 24-month period for individuals currently not using a hybrid closed loop device
Omnipod 5 and Medtronic 780G are hybrid closed loop devices that provide automated insulin delivery.
Experimental: current HCL non-user: HCL x 12 months, then HCL x an additional 12 months
Hybrid closed loop device over a 12-month period for individuals currently not using a hybrid closed loop device, and then a hybrid closed loop device for an additional 12 months
Omnipod 5 and Medtronic 780G are hybrid closed loop devices that provide automated insulin delivery.
Experimental: current HCL non-user: HCL x 12 months, then HCL + HARPdoc x 12 months
Hybrid closed loop device over a 12-month period for individuals currently not using a hybrid closed loop device, then a hybrid closed loop device plus HARPdoc education for an additional 12 months
Omnipod 5 and Medtronic 780G are hybrid closed loop devices that provide automated insulin delivery.
The HARPdoc program targets cognitions around hypoglycemia that act as barriers to hypoglycemia avoidance and recovery of awareness using motivational and cognitive approaches, delivered by diabetes educators, trained and supported by a clinical psychologist, in small group format.
Active Comparator: current HCL non-user: Usual Care and My HypoCOMPaSS x 12 months, then HCL x 12 months
Usual Care and My HypoCOMPaSS education over 12 months for individuals currently not using a hybrid closed loop device, then hybrid closed loop device for 12 months
Omnipod 5 and Medtronic 780G are hybrid closed loop devices that provide automated insulin delivery.
My HypoCOMPaSS is a brief, standardized psycho-educational program delivered in small groups. Facilitated discussions focus on advocating rigorous avoidance of hypoglycemia while maintaining time in target glycemic range.
Active Comparator: current HCL non-user: Usual Care and My HypoCOMPaSS x 24 months
Usual Care and My HypoCOMPaSS education over 24 months for individuals currently not using a hybrid closed loop device
My HypoCOMPaSS is a brief, standardized psycho-educational program delivered in small groups. Facilitated discussions focus on advocating rigorous avoidance of hypoglycemia while maintaining time in target glycemic range.
Experimental: current HCL user: HCL x 24 months
Hybrid closed loop device over a 24-month period for individuals currently using a hybrid closed loop device
Omnipod 5 and Medtronic 780G are hybrid closed loop devices that provide automated insulin delivery.
Experimental: current HCL user: HCL x 12 months, then HCL x an additional 12 months
Hybrid closed loop device over a 12-month period for individuals currently using a hybrid closed loop device, and then a hybrid closed loop device for an additional 12 months
Omnipod 5 and Medtronic 780G are hybrid closed loop devices that provide automated insulin delivery.
Experimental: current HCL user: HCL x 12 months, then HCL + HARPdoc x 12 months
Hybrid closed loop device over a 12-month period for individuals currently using a hybrid closed loop device, then a hybrid closed loop device plus HARPdoc education for an additional 12 months
Omnipod 5 and Medtronic 780G are hybrid closed loop devices that provide automated insulin delivery.
The HARPdoc program targets cognitions around hypoglycemia that act as barriers to hypoglycemia avoidance and recovery of awareness using motivational and cognitive approaches, delivered by diabetes educators, trained and supported by a clinical psychologist, in small group format.
Active Comparator: current HCL user: HCL and My HypoCOMPaSS x 12 months, then HCL x 12 months
Hybrid closed loop device and My HypoCOMPaSS education over 12 months for individuals currently using a hybrid closed loop device, then hybrid closed loop device for 12 months
Omnipod 5 and Medtronic 780G are hybrid closed loop devices that provide automated insulin delivery.
My HypoCOMPaSS is a brief, standardized psycho-educational program delivered in small groups. Facilitated discussions focus on advocating rigorous avoidance of hypoglycemia while maintaining time in target glycemic range.
Active Comparator: current HCL user: HCL + My HypoCOMPaSS x 12 months, then HCL + My HypoCOMPaSS + HARPDOC x 12 months
Hybrid closed loop device and My HypoCOMPaSS education over 12 months for individuals currently using a hybrid closed loop device, then hybrid closed loop device plus My HypoCOMPaSS eduction + HARPdoc education for 12 months
Omnipod 5 and Medtronic 780G are hybrid closed loop devices that provide automated insulin delivery.
The HARPdoc program targets cognitions around hypoglycemia that act as barriers to hypoglycemia avoidance and recovery of awareness using motivational and cognitive approaches, delivered by diabetes educators, trained and supported by a clinical psychologist, in small group format.
My HypoCOMPaSS is a brief, standardized psycho-educational program delivered in small groups. Facilitated discussions focus on advocating rigorous avoidance of hypoglycemia while maintaining time in target glycemic range.
Experimental: current HCL user: HCL + My HypoCOMPaSS x 24 months
Hybrid closed loop device plus My HypoCOMPaSS education over a 24-month period for individuals currently using a hybrid closed loop device
Omnipod 5 and Medtronic 780G are hybrid closed loop devices that provide automated insulin delivery.
My HypoCOMPaSS is a brief, standardized psycho-educational program delivered in small groups. Facilitated discussions focus on advocating rigorous avoidance of hypoglycemia while maintaining time in target glycemic range.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
epinephrine (pg/ml)
Time Frame: measured during the clamp studies at 0 (baseline), 12, and 24 months
a change in epinephrine (pg/ml) that exceeds 125 pg/ml between (1) 12 months and baseline, and (2) 24 months and baseline
measured during the clamp studies at 0 (baseline), 12, and 24 months
Towler questionnaire
Time Frame: measured during the clamp studies at 0 (baseline), 12, and 24 months
the Towler questionnaire consists of 12 questions each on a 0-6 Likert scale; a change in the questionnaire that exceeds 20% between (1) 12 months and baseline, and (2) 24 months and baseline
measured during the clamp studies at 0 (baseline), 12, and 24 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
glucose infusion rate
Time Frame: measured during the clamp studies at 0 (baseline), 12, and 24 months
glucose infusion rate
measured during the clamp studies at 0 (baseline), 12, and 24 months
HbA1c
Time Frame: measured during the clamp studies at 0 (baseline), 12, and 24 months
glycated hemoglobin
measured during the clamp studies at 0 (baseline), 12, and 24 months
% of time with sensor hypoglycemia <70 mg/dL
Time Frame: measured during the four weeks prior to each clamp study at 0 (baseline), 12, and 24 months
% of time with hypoglycemia <70 mg/dL determined from the continuous glucose monitor (CGM) sensor
measured during the four weeks prior to each clamp study at 0 (baseline), 12, and 24 months
% of time with sensor hypoglycemia <54 mg/dL
Time Frame: measured during the four weeks prior to each clamp study at 0 (baseline), 12, and 24 months
% of time with hypoglycemia <54 mg/dL determined from the continuous glucose monitor (CGM) sensor
measured during the four weeks prior to each clamp study at 0 (baseline), 12, and 24 months
number of hypoglycemia events
Time Frame: measured during the four weeks prior to each clamp study at 0 (baseline), 12, and 24 months
number of hypoglycemia events determined from the continuous glucose monitor (CGM) sensor
measured during the four weeks prior to each clamp study at 0 (baseline), 12, and 24 months
% time with sensor glucose in range
Time Frame: measured during the four weeks prior to each clamp study at 0 (baseline), 12, and 24 months
% time with glucose in range determined from the continuous glucose monitor (CGM) sensor
measured during the four weeks prior to each clamp study at 0 (baseline), 12, and 24 months
sensor glucose coefficient of variation
Time Frame: measured during the four weeks prior to each clamp study at 0 (baseline), 12, and 24 months
sensor glucose coefficient of variation determined from the continuous glucose monitor (CGM) sensor
measured during the four weeks prior to each clamp study at 0 (baseline), 12, and 24 months
sensor use as the average numbers of days per week
Time Frame: measured during the four weeks prior to each clamp study at 0 (baseline), 12, and 24 months
sensor use as the average number of days per week determined from the continuous glucose monitor (CGM) sensor
measured during the four weeks prior to each clamp study at 0 (baseline), 12, and 24 months
glycemia risk index
Time Frame: measured during the four weeks prior to each clamp study at 0 (baseline), 12, and 24 months
glycemia risk index determined from the continuous glucose monitor (CGM) sensor
measured during the four weeks prior to each clamp study at 0 (baseline), 12, and 24 months
Trail Making Test - Part B
Time Frame: measured during the clamp studies at 0 (baseline), 12, and 24 months
amount of time required to complete the Trail Making Test - Part B
measured during the clamp studies at 0 (baseline), 12, and 24 months
Four Choice Reaction Time
Time Frame: measured during the clamp studies at 0 (baseline), 12, and 24 months
Four Choice Reaction Time, which measures reaction time and motor coordination
measured during the clamp studies at 0 (baseline), 12, and 24 months
sleep duration
Time Frame: measured during the two weeks prior to each clamp study at 0 (baseline), 12, and 24 months
sleep duration determined from an activity monitor smartwatch
measured during the two weeks prior to each clamp study at 0 (baseline), 12, and 24 months
sleep quality
Time Frame: measured during the two weeks prior to each clamp study at 0 (baseline), 12, and 24 months
sleep quality determined by an activity monitor smartwatch
measured during the two weeks prior to each clamp study at 0 (baseline), 12, and 24 months
24-hour step count
Time Frame: measured during the two weeks prior to each clamp study at 0 (baseline), 12, and 24 months
24-hour step count determined by an activity monitor smartwatch
measured during the two weeks prior to each clamp study at 0 (baseline), 12, and 24 months
exercise bouts
Time Frame: measured during the two weeks prior to each clamp study at 0 (baseline), 12, and 24 months
exercise bouts determined by an activity monitor smartwatch
measured during the two weeks prior to each clamp study at 0 (baseline), 12, and 24 months
resting heart rate
Time Frame: measured during the two weeks prior to each clamp study at 0 (baseline), 12, and 24 months
resting heart rate determined by an activity monitor smartwatch
measured during the two weeks prior to each clamp study at 0 (baseline), 12, and 24 months
heart rate during exercise
Time Frame: measured during the two weeks prior to each clamp study at 0 (baseline), 12, and 24 months
heart rate during exercise determined by an activity monitor smartwatch
measured during the two weeks prior to each clamp study at 0 (baseline), 12, and 24 months
heart rate variability
Time Frame: measured during the two weeks prior to each clamp study at 0 (baseline), 12, and 24 months
heart rate variability determined by an activity monitor smartwatch
measured during the two weeks prior to each clamp study at 0 (baseline), 12, and 24 months
Hypo-METRICS questionnaire
Time Frame: measured two weeks prior to each clamp study at 0 (baseline), 12, and 24 months
Hypo-METRICS questionnaire, a Person-Reported Outcome Measure (PROM) specific to hypoglycemia
measured two weeks prior to each clamp study at 0 (baseline), 12, and 24 months
Hypoglycemia Fear Survey-II
Time Frame: measured two weeks prior to each clamp study at 0 (baseline), 12, and 24 months
Hypoglycemia Fear Survey-II, a Person-Reported Outcome Measure (PROM) specific to hypoglycemia
measured two weeks prior to each clamp study at 0 (baseline), 12, and 24 months
Attitudes to Awareness of Hypoglycaemia
Time Frame: measured two weeks prior to each clamp study at 0 (baseline), 12, and 24 months
Attitudes to Awareness of Hypoglycaemia, a Person-Reported Outcome Measure (PROM) specific to hypoglycemia
measured two weeks prior to each clamp study at 0 (baseline), 12, and 24 months
Type 1 Diabetes Distress Scale
Time Frame: measured two weeks prior to each clamp study at 0 (baseline), 12, and 24 months
Type 1 Diabetes Distress Scale, a Person-Reported Outcome Measure (PROM) specific to hypoglycemia
measured two weeks prior to each clamp study at 0 (baseline), 12, and 24 months
Diabetes Self-Management Questionnaire
Time Frame: measured two weeks prior to each clamp study at 0 (baseline), 12, and 24 months
Diabetes Self-Management Questionnaire, a Person-Reported Outcome Measure (PROM) specific to hypoglycemia
measured two weeks prior to each clamp study at 0 (baseline), 12, and 24 months
Diabetes Management Experiences Questionnaire
Time Frame: measured two weeks prior to each clamp study at 0 (baseline), 12, and 24 months
Diabetes Management Experiences Questionnaire, a Person-Reported Outcome Measure (PROM) specific to hypoglycemia
measured two weeks prior to each clamp study at 0 (baseline), 12, and 24 months
PROMIS Sleep Disturbance - Short Form 8a
Time Frame: measured two weeks prior to each clamp study at 0 (baseline), 12, and 24 months
PROMIS Sleep Disturbance - Short Form 8a
measured two weeks prior to each clamp study at 0 (baseline), 12, and 24 months
12-Item Hypoglycemia Impact Profile
Time Frame: measured two weeks prior to each clamp study at 0 (baseline), 12, and 24 months
12-Item Hypoglycemia Impact Profile, a Person-Reported Outcome Measure (PROM) specific to hypoglycemia
measured two weeks prior to each clamp study at 0 (baseline), 12, and 24 months
EQ-5D-5L
Time Frame: measured two weeks prior to each clamp study at 0 (baseline), 12, and 24 months
EQ-5D-5L, a quality-of-life scale with 5 dimensions
measured two weeks prior to each clamp study at 0 (baseline), 12, and 24 months
device-related adverse events
Time Frame: throughout the duration of the 24 months of follow-up
device-related adverse events
throughout the duration of the 24 months of follow-up
diabetic ketoacidosis (DKA) events
Time Frame: throughout the duration of the 24 months of follow-up
diabetic ketoacidosis (DKA) events
throughout the duration of the 24 months of follow-up
major adverse cardiovascular events (MACE)
Time Frame: throughout the duration of the 24 months of follow-up
major adverse cardiovascular events (MACE)
throughout the duration of the 24 months of follow-up
all-cause mortality
Time Frame: throughout the duration of the 24 months of follow-up
all-cause mortality
throughout the duration of the 24 months of follow-up
geometric mean of plasma glucagon
Time Frame: measured during the clamp studies at 0 (baseline), 12, and 24 months
geometric mean of plasma glucagon
measured during the clamp studies at 0 (baseline), 12, and 24 months
geometric mean of plasma pancreatic polypeptide
Time Frame: measured during the clamp studies at 0 (baseline), 12, and 24 months
geometric mean of plasma pancreatic polypeptide
measured during the clamp studies at 0 (baseline), 12, and 24 months
geometric mean of plasma free fatty acids
Time Frame: measured during the clamp studies at 0 (baseline), 12, and 24 months
geometric mean of plasma free fatty acids
measured during the clamp studies at 0 (baseline), 12, and 24 months
Hypoglycemic Confidence Scale
Time Frame: measured two weeks prior to each clamp study at 0 (baseline), 12, and 24 months
Hypoglycemic Confidence Scale, a Person-Reported Outcome Measure (PROM) specific to hypoglycemia, the range is 0 through 27 and higher scores correspond to higher confidence
measured two weeks prior to each clamp study at 0 (baseline), 12, and 24 months
Hospital Anxiety and Depression Scale
Time Frame: measured two weeks prior to each clamp study at 0 (baseline), 12, and 24 months, the range is 0 through 42 and higher scores correspond to higher anxiety and depression
Hospital Anxiety and Depression Scale
measured two weeks prior to each clamp study at 0 (baseline), 12, and 24 months, the range is 0 through 42 and higher scores correspond to higher anxiety and depression
severe hypoglycemic events, self-reported on a CLEAR data collection form
Time Frame: throughout the duration of the 24 months of follow-up
severe hypoglycemic events, self-reported on a CLEAR data collection form
throughout the duration of the 24 months of follow-up
number of participants with hospitalizations
Time Frame: throughout the duration of the 24 months of follow-up
number of participants with hospitalizations
throughout the duration of the 24 months of follow-up
number of participants with emergency room (ER) visits
Time Frame: throughout the duration of the 24 months of follow-up
number of participants with emergency room (ER) visits
throughout the duration of the 24 months of follow-up

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Vernon M Chinchilli, PhD, Penn State College of Medicine
  • Study Chair: Elizabeth R Seaquist, MD, University of Minnesota
  • Study Chair: Simon Heller, MD, University of Sheffield

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

July 1, 2024

Primary Completion (Estimated)

June 30, 2027

Study Completion (Estimated)

December 31, 2027

Study Registration Dates

First Submitted

March 5, 2024

First Submitted That Met QC Criteria

March 15, 2024

First Posted (Actual)

March 22, 2024

Study Record Updates

Last Update Posted (Actual)

March 26, 2024

Last Update Submitted That Met QC Criteria

March 24, 2024

Last Verified

March 1, 2024

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

The release data sets will be stored at the NIDDK Central Repository.

The release data sets will de-identified, i.e., they will not contain names, social security numbers, addresses, phone numbers, health care records, and/or similar protected health information. In addition, the release data sets will have an anonymous study ID that is linked to an individual only in the participant records at the Biostatistics Research Center at the Penn State College of Medicine.

IPD Sharing Time Frame

The timeline for data sharing from the Impaired Awareness of Hypoglycemia Consortium will meet NIH data sharing requirements, such as one year after the Consortium investigators have published the primary manuscript. The Biostatistics Research Center at the Penn State College of Medicine will make data available after the acceptance for publication of the main findings that address the specific aims of the study.

IPD Sharing Access Criteria

Investigators external to the Consortium will be able to request the data from the NIDDK Central Repository. They will be required to show proof of their local IRB approval.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP
  • ICF
  • ANALYTIC_CODE
  • CSR

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

Yes

product manufactured in and exported from the U.S.

Yes

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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