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

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

Descripción general del estudio

Descripción detallada

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.

Tipo de estudio

Intervencionista

Inscripción (Actual)

16

Fase

  • No aplica

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Ubicaciones de estudio

    • California
      • Stanford, California, Estados Unidos, 94305
        • Stanford University School of Medicine

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

18 años a 44 años (Adulto)

Acepta Voluntarios Saludables

No

Géneros elegibles para el estudio

Todos

Descripción

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

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Viabilidad del dispositivo
  • Asignación: No aleatorizado
  • Modelo Intervencionista: Asignación Secuencial
  • Enmascaramiento: Único

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Sin intervención: Blinded Sensor
Subjects will wear a blinded Dexcom G4P (Generation 4 Platinum) AP (Artificial Pancreas) glucose sensor for a week
Experimental: 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.
Experimental: 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.

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Mean glucose
Periodo de tiempo: change over 5 days
Dexcom G4P AP mean glucose
change over 5 days

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
% time <50 mg/dl
Periodo de tiempo: change over 5 days
Fraction of Dexcom G4P AP readings <60 mg/dl
change over 5 days
% time <70 mg/dl
Periodo de tiempo: change over 5 days
Fraction of Dexcom G4P AP readings <70 mg/dl
change over 5 days
% time 70-120 mg/dl
Periodo de tiempo: change over 5 days
Fraction of Dexcom G4P AP readings 70-120 mg/dl
change over 5 days
% time 70-180 mg/dl
Periodo de tiempo: change over 5 days
Fraction of Dexcom G4P AP readings 70-180 mg/dl
change over 5 days
% time >180 mg/dl
Periodo de tiempo: change over 5 days
Fraction of Dexcom G4P AP readings >180 mg/dl
change over 5 days
% time >250 mg/dl
Periodo de tiempo: change over 5 days
Fraction of Dexcom G4P AP readings >250 mg/dl
change over 5 days
% time < 60 mg/dl
Periodo de tiempo: Change over 5 days
Fraction of Dexcom G4AP readings < 60 mg/dl
Change over 5 days

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

Investigadores

  • Investigador principal: Bruce A Buckingham, MD, Stanford School of Medicine, Pediatric Endocrinology

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio

1 de agosto de 2015

Finalización primaria (Actual)

1 de julio de 2016

Finalización del estudio (Actual)

1 de julio de 2016

Fechas de registro del estudio

Enviado por primera vez

18 de julio de 2015

Primero enviado que cumplió con los criterios de control de calidad

29 de agosto de 2015

Publicado por primera vez (Estimar)

1 de septiembre de 2015

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

21 de junio de 2018

Última actualización enviada que cumplió con los criterios de control de calidad

19 de junio de 2018

Última verificación

1 de junio de 2018

Más información

Términos relacionados con este estudio

Plan de datos de participantes individuales (IPD)

¿Planea compartir datos de participantes individuales (IPD)?

NO

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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