- ICH GCP
- Registr klinických studií v USA
- Klinická studie NCT05134025
The SMART A Exercise Study :''The SMART Study'' (SMART)
Optimising Glycaemia Around Dynamic Physical Exercise With Advanced Hybrid-closed-loop Therapy Use in Type 1 Diabetes: ''The SMART Study''
Despite the promising data emanating from trials investigating the effectiveness of advanced hybrid closed loop (AHCL) insulin delivery systems in managing glycaemia in those with type 1 diabetes (T1D), we currently know little about their efficacy in optimising glycaemia when physical activity is factored into the equation. With the introduction of new AHCL systems that have novel technological features, we are left with important questions of how to optimise their use around physical exercise to not only minimise dysglycaemia, but also encourage individuals with T1D to lead a physically active lifestyle for the associated wider health benefits.
This will be a three-period, randomised, cross-over study with a single-hormone (insulin) AHCL system that compares the efficacy of three insulin management strategies: (i) unannounced exercise and a full dose of meal-time insulin 90-minutes prior to commencement, (ii) a 25% reduced dose of meal-time insulin with exercise announcement 90-minutes prior to commencement and (iii) a 25% dose reduction in meal-time insulin with exercise announcement 45-minutes prior to commencement, in optimising TIR around dynamic physical exercise in adults with T1D.
Přehled studie
Detailní popis
Typ studie
Zápis (Aktuální)
Fáze
- Nelze použít
Kontakty a umístění
Studijní místa
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Gentofte, Dánsko, 2820
- Steno Diabetes Center Copenhagen
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Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
Přijímá zdravé dobrovolníky
Pohlaví způsobilá ke studiu
Popis
Inclusion Criteria:
• Type 1 diabetes ≥2 years.
HbA1c;
- 58-63 mmol/mol (maximum 30% of participants) OR
- ≥ 64 mmol/mol (minimum 70% of participants)
- Insulin pump treatment ≥12 months
- CGM or isCGM use ≥6 months
- Novorapid use ≥4 weeks
- Carbohydrate counting and use of the insulin pump bolus calculator for most snacks and meals.
- Carbohydrate intake >80 grams per day (assessed by review of intake recorded in the insulin pump during the 2 weeks prior to the screening visit)
Exclusion Criteria:
• Breast-feeding, pregnancy or planning to become pregnant.
- Use of anti-diabetic medicine (other than insulin), corticosteroids or other drugs affecting glucose metabolism during the study period or within 30 days prior to study start.
- Use of hybrid closed-loop systems
- Daily use of paracetamol (acetaminophen)
- Alcohol or drug abuse.
- Severe cardiac disease or retinopathy contraindicating HbA1c <53 mmol/mol.
- Other concomitant medical or psychological condition that according to the investigator's assessment makes the person unsuitable for study participation.
- Lack of compliance with key study procedures at the discretion of the investigator.
- Unacceptable adverse events at the discretion of the investigator.
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Přidělení: Randomizované
- Intervenční model: Crossover Assignment
- Maskování: Žádné (otevřený štítek)
Zbraně a zásahy
Skupina účastníků / Arm |
Intervence / Léčba |
---|---|
Experimentální: SMART A1
A full dose of meal-time insulin with announced exercise immediately prior to commencement
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Alteration in the pump setting prior to exercise commencement
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Experimentální: SMART A2
a 25% dose reduction in meal-time insulin with exercise announcement 90-minutes prior to commencement
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Alteration in the pump setting prior to exercise commencement
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Experimentální: SMART A3
a 25% dose reduction in meal-time insulin with exercise announcement 45-minutes prior to commencement
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Alteration in the pump setting prior to exercise commencement
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Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
---|---|---|
Comparison of TIR in blood glucose values during, and 1-hour after, dynamic physical exercise.
Časové okno: -90 min to +105 min
|
To compare the amount of time spent with blood glucose values within the target range during, and 1-hour after, dynamic physical exercise
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-90 min to +105 min
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Další výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
---|---|---|
Comparison of the occurrence of BG hypoglycaemic events
Časové okno: -90 min to +105 min
|
Comparison of the occurrence of blood glucose hypoglycaemic events before during and 1 hour after exercise
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-90 min to +105 min
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Comparison of the depth of BG hypoglycaemic events
Časové okno: -90 min to +105 min
|
Comparison of the depth of blood glucose hypoglycaemic events before during and 1 hour after exercise
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-90 min to +105 min
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Comparison of mean BG concentrations
Časové okno: -90 min to +105 min
|
Comparison of mean blood glucose concentrations before during and 1 hour after exercise
|
-90 min to +105 min
|
Comparison of the standard deviation in BG concentrations
Časové okno: -90 min to +105 min
|
Comparison of the standard deviation in blood glucose concentrations before during and 1 hour after exercise
|
-90 min to +105 min
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Comparison of the coefficient of variation in BG concentrations
Časové okno: -90 min to +105min
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Comparison of the coefficient of variation in blood glucose concentrations before during and 1 hour after exercise
|
-90 min to +105min
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Comparison of the minimum BG concentration
Časové okno: -90 min to +105min
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Comparison of the minimum blood glucose concentration before during and 1 hour after exercise
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-90 min to +105min
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Comparison of the maximum BG concentration
Časové okno: -90 min to +105min
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Comparison of the maximum blood glucose concentration before during and 1 hour after exercise
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-90 min to +105min
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ΔBGexercise: Changes in BG concentrations during exercise
Časové okno: 0 min to +45 min
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ΔBGexercise: Changes in blood glucose concentrations during exercise
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0 min to +45 min
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ΔiGexercise: Changes in iG concentrations during exercise
Časové okno: 0 min to +45 min
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ΔiGexercise: Changes in interstitial glucose concentrations during exercise
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0 min to +45 min
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ΔBGfeeding: Change in BG concentrations after feeding
Časové okno: -90 min to 0min
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ΔBGfeeding: Change in blood glucose concentrations after feeding
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-90 min to 0min
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ΔiGfeeding: Change in iG concentrations after feeding
Časové okno: -90 min to 0min
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ΔiGfeeding: Change in interstitial glucose concentrations after feeding
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-90 min to 0min
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Comparison of TBR level 2 in iG values
Časové okno: -90 min to +105 min
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Comparison of TBR level 2 in interstitial glucose values before during and 1 hour after exercise
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-90 min to +105 min
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Comparison of TBR level 1 in iG values
Časové okno: -90 min to +105 min
|
Comparison of TBR level 1 in interstitial glucose values before during and 1 hour after exercise
|
-90 min to +105 min
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Comparison of TAR level 1 in iG values
Časové okno: -90 min to +105 min
|
Comparison of the amount of time spent with interstitial glucose values above the target range level 1 before during and 1 hour after exercise
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-90 min to +105 min
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Comparison of TAR level 2 in iG values
Časové okno: -90 min to +105 min
|
Comparison of the amount of time spent with interstitial glucose values above the target range level 2 before during and 1 hour after exercise
|
-90 min to +105 min
|
Comparison of mean iG concentrations
Časové okno: -90 min to +105 min
|
Comparison of mean interstitial glucose concentrations before during and 1 hour after exercise
|
-90 min to +105 min
|
Comparison of the standard deviation in iG concentrations
Časové okno: -90 min to +105 min
|
Comparison of the standard deviation in interstitial glucose concentrations before during and 1 hour after exercise
|
-90 min to +105 min
|
Comparison of the coefficient of variation in iG concentrations
Časové okno: -90 min to +105 min
|
Comparison of the coefficient of variation in interstitial glucose concentrations before during and 1 hour after exercise
|
-90 min to +105 min
|
Comparison of the minimum iG concentration
Časové okno: -90 min to +105 min
|
Comparison of the minimum interstitial glucose concentration before during and 1 hour after exercise
|
-90 min to +105 min
|
Comparison of the maximum iG concentration
Časové okno: -90 min to +105 min
|
Comparison of the maximum interstitial glucose concentration before during and 1 hour after exercise
|
-90 min to +105 min
|
Spolupracovníci a vyšetřovatelé
Sponzor
Spolupracovníci
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Aktuální)
Primární dokončení (Aktuální)
Dokončení studie (Aktuální)
Termíny zápisu do studia
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Více informací
Termíny související s touto studií
Další relevantní podmínky MeSH
Další identifikační čísla studie
- SMART A
Informace o lécích a zařízeních, studijní dokumenty
Studuje lékový produkt regulovaný americkým FDA
Studuje produkt zařízení regulovaný americkým úřadem FDA
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