Hybrid Artificial Pancreas in Home Setting (AP Hybrid)
5 novembre 2015 mis à jour par: University Hospital, Montpellier
Assessment of Hybrid Use of an Artificial Pancreas in a Home Setting for Two Months in Patients With Type 1 Diabetes
The primary purpose of this study is the evaluate an Artificial Pancreas during 2 months in home setting in Type 1 Diabetic patients
Aperçu de l'étude
Statut
Complété
Les conditions
Intervention / Traitement
Description détaillée
During this study, we propose to assess an Artificial Pancreas in a group of Type 1 diabetic patients who will participate in two study periods of two-month duration with an insulin pump and a Continuous Glucose Monitoring (CGM) device.
During one of these periods, called HYBRID Period, the patient will use the AP model when at home, from dinner to wake-up time whereas the patient will self manage glucose control with insulin pump and CGM for the rest of the day.
During the control period called OPEN Period, patient self management of diabetes by insulin pump and CGM will be done at all times.
Overall, an increase of time spent in range when using artificial pancreas in the hybrid period should be observed with a reduction of both hypo and hyperglycemia episodes.
Type d'étude
Interventionnel
Inscription (Réel)
36
Phase
- Phase 2
Contacts et emplacements
Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.
Critères de participation
Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.
Critère d'éligibilité
Âges éligibles pour étudier
18 ans à 70 ans (Adulte, Adulte plus âgé)
Accepte les volontaires sains
Non
Sexes éligibles pour l'étude
Tout
La description
Inclusion Criteria:
- Age ≥ 18 et < 70 years old
- Having diabetes according to WHO criteria for at least 6 months, and Type 1 diabetes according to ADA criteria
- Under basal-bolus insulin therapy using an external insulin pump for at least 3 months
- BMI < 35 kg/m²
- Willing to wear a CGM device for the whole duration of the study, except during washout period, combined with the DiAs platform during the evening and night-time for 2 months
- Trained in carbohydrate counting
- HbA1c > 7.5 % and < 10%
- If on antihypertensive, thyroid, anti-depressant or lipid lowering medication, stability on the medication for at least 1 month prior to study inclusion
- Willing to undergo all study procedures
- Informed consent signed
Exclusion criteria:
- Pregnancy or breast feeding, or intention to be pregnant during the study duration
- Use of a medication that significantly impacts glucose metabolism, e.g. steroids
- Uncontrolled hypertension with resting blood pressure over 140/90 mmHg
- Patient plans to go abroad during the trial period
- Patient is expected to be out-of-home in the evening and during night time (e.g. shift-workers, etc.) more than 25% of a study period
- Patient does not hold any nearby party for assistance if needed
- Patient with severe hypoglycemia including coma, mental confusion and/or convulsions requesting IV glucose injection or glucagon injection during the last year.
- Presence of any malignant disease, unless considered as cured for more than 10 years
- History of acute cardiovascular event during the prior year
- History of diabetic keto-acidosis during the prior 6 months
- Renal insufficiency with creatinin > 150 μmol/L
- Impairment of liver status estimated from ASAT/ALAT plasma levels > 2x upper limits of normal values
- Impaired cognitive or psychological abilities which may result in defective adherence to study conditions
Plan d'étude
Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation croisée
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
|
Expérimental: HYBRID-OPEN
Patients are randomized on the schedule; hybrid period and after open period. During the HYBRID Period, the patient will use the AP model when at home, from dinner to wake-up time whereas the patient will self manage glucose control with insulin pump and CGM for the rest of the day. During the control period called OPEN Period, patient self management of diabetes by insulin pump and CGM will be done at all times. Overall, an increase of time spent in range when using artificial pancreas in the hybrid period should be observed with a reduction of both hypo and hyperglycemia episodes. |
During the HYBRID Period, the patient will use the AP model when at home, from dinner to wake-up time whereas the patient will self manage glucose control with insulin pump and CGM for the rest of the day.
During the control period called OPEN Period, patient self management of diabetes by insulin pump and CGM will be done at all times.
|
|
Expérimental: OPEN-HYBRID
Patients are randomized on the schedule: open period and after hybrid period. During the control period called OPEN Period, patient self management of diabetes by insulin pump and CGM will be done at all times. During the HYBRID Period, the patient will use the AP model when at home, from dinner to wake-up time whereas the patient will self manage glucose control with insulin pump and CGM for the rest of the day. Overall, an increase of time spent in range when using artificial pancreas in the hybrid period should be observed with a reduction of both hypo and hyperglycemia episodes. |
During the HYBRID Period, the patient will use the AP model when at home, from dinner to wake-up time whereas the patient will self manage glucose control with insulin pump and CGM for the rest of the day.
During the control period called OPEN Period, patient self management of diabetes by insulin pump and CGM will be done at all times.
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Délai |
|---|---|
|
Percent time spent in target range (3.9-10.0 mmol/L or 70-180 mg/dL) during each study period
Délai: during 2 months-hybrid period and during 2 months-open period
|
during 2 months-hybrid period and during 2 months-open period
|
Mesures de résultats secondaires
Mesure des résultats |
Délai |
|---|---|
|
Low Blood Glucose Index (LBGI)
Délai: for each period of 2 month (hybrid period and open period)
|
for each period of 2 month (hybrid period and open period)
|
Collaborateurs et enquêteurs
C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.
Parrainer
Les enquêteurs
- Chercheur principal: Eric ER RENARD, MD, University Hospital, Montpellier
Publications et liens utiles
La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.
Publications générales
- Renard E, Farret A, Kropff J, Bruttomesso D, Messori M, Place J, Visentin R, Calore R, Toffanin C, Di Palma F, Lanzola G, Magni P, Boscari F, Galasso S, Avogaro A, Keith-Hynes P, Kovatchev B, Del Favero S, Cobelli C, Magni L, DeVries JH; AP@home Consortium. Day-and-Night Closed-Loop Glucose Control in Patients With Type 1 Diabetes Under Free-Living Conditions: Results of a Single-Arm 1-Month Experience Compared With a Previously Reported Feasibility Study of Evening and Night at Home. Diabetes Care. 2016 Jul;39(7):1151-60. doi: 10.2337/dc16-0008. Epub 2016 May 5.
- Kropff J, Del Favero S, Place J, Toffanin C, Visentin R, Monaro M, Messori M, Di Palma F, Lanzola G, Farret A, Boscari F, Galasso S, Magni P, Avogaro A, Keith-Hynes P, Kovatchev BP, Bruttomesso D, Cobelli C, DeVries JH, Renard E, Magni L; AP@home consortium. 2 month evening and night closed-loop glucose control in patients with type 1 diabetes under free-living conditions: a randomised crossover trial. Lancet Diabetes Endocrinol. 2015 Dec;3(12):939-47. doi: 10.1016/S2213-8587(15)00335-6. Epub 2015 Sep 30.
Dates d'enregistrement des études
Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.
Dates principales de l'étude
Début de l'étude
1 mai 2014
Achèvement primaire (Réel)
1 juin 2015
Achèvement de l'étude (Réel)
1 juin 2015
Dates d'inscription aux études
Première soumission
29 mai 2014
Première soumission répondant aux critères de contrôle qualité
30 mai 2014
Première publication (Estimation)
2 juin 2014
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Estimation)
6 novembre 2015
Dernière mise à jour soumise répondant aux critères de contrôle qualité
5 novembre 2015
Dernière vérification
1 novembre 2015
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- 8628 4
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