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An Outpatient Study of Automated Blood Glucose Control With an Insulin-Only Bionic Pancreas

19. juni 2018 opdateret af: Bruce A. Buckingham
This is an open-label, non-randomized, pilot study to determine the safety and feasibility of the insulin-only bionic pancreas.

Studieoversigt

Status

Afsluttet

Detaljeret beskrivelse

A total of 16 subjects, ages 18-45, will be enrolled in this crossover study. The study will consist of three 7-day study arms in the following order, one usual care arm, one bionic pancreas insulin only arm with a static glucose target, and one bionic pancreas insulin only arm with at dynamic glucose target.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

16

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

    • California
      • Stanford, California, Forenede Stater, 94305
        • Stanford University School of Medicine

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år til 44 år (Voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Type 1 diabetes for at least 1 year
  • insulin pump for ≥ 6 months
  • Prescription medication regimen stable for > 1 month
  • Subject comprehends written English
  • Female patients who are sexually active must be on acceptable method of contraception e.g. oral contraceptive pill, diaphragm, IUD (Intrauterine Device)
  • Female patients must have a negative urine pregnancy test
  • Informed Consent Form signed by the subject
  • Lives and works within a 60 minute drive-time radius of Stanford University
  • Willing to remain within a 60 minute drive-time radius of Stanford University during all 3 of the 7-day study arms (21 days)
  • Have someone over 18 years of age who lives with them,

Exclusion Criteria:

  • Current alcohol abuse (intake averaging > 3 drinks daily in last 30 days), use of marijuana within 1 month of enrollment, or other substance abuse (use within the last 6 months of controlled substances other than marijuana without a prescription)
  • Subject has a history of diagnosed medical eating disorder
  • Subject has a history of visual impairment which would not allow subject to participate
  • Subject has an active skin condition that would affect sensor placement
  • Subject has adhesive allergies
  • Subjects requiring an intermediate or long-acting insulin (such as NPH, Neutral Protamine Hagedorn, detemir or glargine)
  • Subjects requiring other anti-diabetic medications other than insulin (oral or injectable)
  • Current use of oral/inhaled glucocorticoids or other medications, which in the judgment of the investigator would be a contraindication to participation in the study
  • Unwilling or unable to refrain from drinking more than 2 drinks in an hour or more than 4 drinks in a day or use of marijuana during the trial
  • Subject has active Graves' disease
  • Subjects with inadequately treated thyroid disease or celiac disease
  • History of liver disease Renal failure on dialysis
  • Personal history of cystic fibrosis, pancreatitis, pancreatic tumor, or any other pancreatic disease besides type 1 diabetes
  • Any known history of coronary artery disease
  • Abnormal EKG (electrocardiogram) consistent with coronary artery disease or increased risk of malignant arrhythmia
  • Congestive heart failure (established history of congestive heart failure , lower extremity edema, paroxysmal nocturnal dyspnea, or orthopnea)
  • History of transient ischemic attack (TIA) or stroke
  • Seizure disorder, history of any non-hypoglycemic seizure within the last two years, or ongoing treatment with anticonvulsants
  • History of hypoglycemic seizures (grand-mal) or coma in the last year
  • History of pheochromocytoma:
  • episodic or treatment refractory (requiring 4 or more medications to achieve normotension) hypertension
  • paroxysms of tachycardia, pallor, or headache
  • personal or family history of MEN 2A (multiple endocrine neoplasia), MEN 2B, neurofibromatosis, or von Hippel-Lindau disease
  • History of adrenal disease or tumor
  • Hypertension with systolic blood pressure ≥160 mm Hg or diastolic blood pressure ≥100 despite treatment
  • Untreated or inadequately treated mental illness
  • Electrically powered implants (e.g. cochlear implants, neurostimulators) that might be susceptible to RF interference
  • Unable to completely avoid acetaminophen for duration of study
  • Established history of allergy or severe reaction to adhesive or tape that must be used in the study
  • History of eating disorder within the last 2 years, such as anorexia, bulimia, or diabulemia or omission of insulin to manipulate weight
  • History of intentional, inappropriate administration of insulin leading to severe hypoglycemia requiring treatment
  • Lives in or frequents areas with poor Verizon wireless network coverage (which would prevent remote monitoring)
  • Any factors that, in the opinion of the site principal investigator or overall principal investigator, would interfere with the safe completion of the study

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Enhedens gennemførlighed
  • Tildeling: Ikke-randomiseret
  • Interventionel model: Sekventiel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Ingen indgriben: Blinded Sensor
Subjects will wear a blinded Dexcom G4P (Generation 4 Platinum) AP (Artificial Pancreas) glucose sensor for a week
Eksperimentel: Fixed set point
Subjects will be in a hotel and use a fixed set point for glucose control for two days initialized at 130 mg/dl. The setpoint will be adjusted, if necessary, over the two days in the hotel before they are sent home for 5 days
Fixed set point arm: A fixed setpoint will be used initially. Staff will observe glucose control over 2 days while subjects remain in a hotel environment, and then over 5 more days in the same subjects in an outpatient setting. The clinical staff will adjust this target up or down by 15 mg/dl based on their glycemic control in the hotel setting.
Eksperimentel: Variable Set Point
Subjects will begin using a "variable" setpoint which will make adjustments based on their past glucose control over the previous day
Variable set point arm: The setpoint will be variable over a 30 mg/dl range and glycemic control will be optimized based on the preceding 24-hour window.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Mean glucose
Tidsramme: change over 5 days
Dexcom G4P AP mean glucose
change over 5 days

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
% time <50 mg/dl
Tidsramme: change over 5 days
Fraction of Dexcom G4P AP readings <60 mg/dl
change over 5 days
% time <70 mg/dl
Tidsramme: change over 5 days
Fraction of Dexcom G4P AP readings <70 mg/dl
change over 5 days
% time 70-120 mg/dl
Tidsramme: change over 5 days
Fraction of Dexcom G4P AP readings 70-120 mg/dl
change over 5 days
% time 70-180 mg/dl
Tidsramme: change over 5 days
Fraction of Dexcom G4P AP readings 70-180 mg/dl
change over 5 days
% time >180 mg/dl
Tidsramme: change over 5 days
Fraction of Dexcom G4P AP readings >180 mg/dl
change over 5 days
% time >250 mg/dl
Tidsramme: change over 5 days
Fraction of Dexcom G4P AP readings >250 mg/dl
change over 5 days
% time < 60 mg/dl
Tidsramme: Change over 5 days
Fraction of Dexcom G4AP readings < 60 mg/dl
Change over 5 days

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Efterforskere

  • Ledende efterforsker: Bruce A Buckingham, MD, Stanford School of Medicine, Pediatric Endocrinology

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. august 2015

Primær færdiggørelse (Faktiske)

1. juli 2016

Studieafslutning (Faktiske)

1. juli 2016

Datoer for studieregistrering

Først indsendt

18. juli 2015

Først indsendt, der opfyldte QC-kriterier

29. august 2015

Først opslået (Skøn)

1. september 2015

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

21. juni 2018

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

19. juni 2018

Sidst verificeret

1. juni 2018

Mere information

Begreber relateret til denne undersøgelse

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

Kliniske forsøg med Diabetes mellitus, type 1

Kliniske forsøg med Fixed set point

Abonner