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Effect of Closed Loop Glucose Control on Exercise-Associated Hypoglycemia (ePID-03)

2017년 11월 9일 업데이트: Medtronic Diabetes
The purpose of the study is to compare the glycemic control during and following aerobic exercise using either an open or closed-loop insulin delivery system.

연구 개요

상태

완전한

개입 / 치료

상세 설명

This is an open-label, single-center, randomized crossover study evaluating the performance of a closed-loop insulin delivery system using a subcutaneous glucose sensor and an external insulin pump and comparing it to an open-loop delivery system during aerobic exercise. Subject participation will be for a maximum of 16 weeks including an outpatient study (up to 6 days) and two inpatient studies (one closed-loop; the other open-loop). The closed- and open-loop visit consists of approximately 67 hours over 4 days and 3 nights.

연구 유형

중재적

등록 (실제)

13

단계

  • 해당 없음

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 장소

    • Connecticut
      • New Haven, Connecticut, 미국, 06519
        • Yale Pediatrics Diabetes Research

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

12년 (어린이, 성인)

건강한 자원 봉사자를 받아들입니다

아니

연구 대상 성별

모두

설명

Inclusion Criteria:

  • Male and female subjects between 12-30 years of age.
  • Subjects must weigh at least 50 kg to accommodate phlebotomy.
  • Previously diagnosed Type 1 Diabetes Mellitus
  • Diabetes duration at least 1 year.
  • Currently treating their diabetes with an insulin pump.
  • A1C of ≤ 9.0 % at time of enrollment.
  • Willing to have an intravenous (IV) line inserted for frequent blood sampling and infusion of glucose if needed.
  • Willing to wear two (2) subcutaneous glucose sensors and two (2) transmitters simultaneously during closed-loop portion of the study.
  • Be in good general health without other acute or chronic illnesses except treated hypothyroidism or celiac disease and asthma not requiring glucocorticoid use.
  • Able to tolerate a 75-minute exercise period of moderate intensity.
  • Speak and understand English.
  • Subject and parent (if minor) must be able to comprehend and sign the informed consent form and other study documents.

Exclusion Criteria:

  • Pregnancy (urine pregnancy test) or lactation, if female.
  • Subject has any major concomitant disease or any physical or psychological disorder within the last five years, which might be considered life threatening, or which might confound the collection or interpretation of the study data.
  • Subject has a cardiac pacemaker or similar device that may be sensitive to radio frequency telemetry.
  • Subject using any of the following medications:

    • glucocorticoids
    • cyclosporine
    • L-asparaginase
    • niacin
    • protease inhibitors
    • anti-psychotics
    • GnRH agonists
    • beta-blockers
    • calcium channel blockers
    • immunosuppressants
    • over-the-counter medications that may effect glucose metabolism.
  • Subject has any of the following conditions

    • insulin allergy
    • severe insulin resistance
    • exercise-induced asthma
    • musculoskeletal problems that may impact ability to complete exercise protocol
    • substance abuse
    • skin ulcers or poor wound healing
    • bleeding disorders
    • chronic infections
    • eating disorders
    • give a history of or are predisposed to major stress
    • any other major organ system disease.
  • Subject has experienced two (2) or more severe hypoglycemic events -seizures/coma requiring assistance in the past six (6) months.
  • Subject has any other condition that in the investigator's opinion warrants exclusion from the study or precludes him/her from completing the protocol.
  • Subjects using dietary supplements within 14 days of study enrollment
  • Subject is currently enrolled in another study.

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 다른
  • 할당: 무작위화되지 않음
  • 중재 모델: 크로스오버 할당
  • 마스킹: 없음(오픈 라벨)

무기와 개입

참가자 그룹 / 팔
개입 / 치료
실험적: Closed Loop (CL) Phase
Insulin pump controlled by closed loop unit and algorithm
간섭 없음: Standard of Care (OL) Phase
Standard of Care (OL) Phase or Open Loop Phase

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Plasma Glucose (PG) Response to Exercise
기간: Begins at start of exercise, at or after 15:00 on the in-patient visit day randomly assigned each subject for exercise; ends at start of the subsequent meal. Median period: 121 minutes (min), interquartile range (IQR): 15 min, range: 93 to 133 min.
PG at start of exercise minus the subsequent PG nadir
Begins at start of exercise, at or after 15:00 on the in-patient visit day randomly assigned each subject for exercise; ends at start of the subsequent meal. Median period: 121 minutes (min), interquartile range (IQR): 15 min, range: 93 to 133 min.
Incidence of Hypoglycemia Immediately Following Exercise
기간: Begins at end of exercise, at or after 16:15 on the in-patient visit day randomly assigned each subject for exercise; ends at 22:00 of same day. Median period: 333 minutes (min), interquartile range (IQR): 28 min, range: 262 to 344 min.
Tally of episodes where either plasma glucose (PG) < 60 mg/dL, or supplemental glucose was administered to prevent imminent PG < 60 mg/dL. Maximum tally of hypoglycemic events within any 30 minute period is 1.
Begins at end of exercise, at or after 16:15 on the in-patient visit day randomly assigned each subject for exercise; ends at 22:00 of same day. Median period: 333 minutes (min), interquartile range (IQR): 28 min, range: 262 to 344 min.
Incidence of Nocturnal Hypoglycemia Following Exercise
기간: Begins at 22:00 on the in-patient visit day randomly assigned each subject for exercise; ends at 6:00 of the subsequent day. Period was 480 minutes (min) for all subjects, both study phases.
Tally of episodes where either plasma glucose (PG) < 60 mg/dL, or supplemental glucose was administered to prevent imminent PG < 60 mg/dL. Maximum tally of hypoglycemic events within any 30 minute period is 1.
Begins at 22:00 on the in-patient visit day randomly assigned each subject for exercise; ends at 6:00 of the subsequent day. Period was 480 minutes (min) for all subjects, both study phases.

2차 결과 측정

결과 측정
측정값 설명
기간
Peak Post-prandial Plasma Glucose (PG)
기간: Union of 6 meal periods (3 per day on study days 2 & 3). A meal period runs from meal start to start of next meal, or 22:00 for 3rd meal of the day. Union of 6 periods median: 1666 minutes (min), interquartile range (IQR): 15 min, range: 1638 to 1680 min.
For each subject and study phase, the six peak PG following each of the six meals were determined. The median of these six peaks became the one peak post-prandial PG value representing each subject and study phase.
Union of 6 meal periods (3 per day on study days 2 & 3). A meal period runs from meal start to start of next meal, or 22:00 for 3rd meal of the day. Union of 6 periods median: 1666 minutes (min), interquartile range (IQR): 15 min, range: 1638 to 1680 min.
Nadir Plasma Glucose (PG) Immediately Following Exercise
기간: Begins at start of exercise, at or after 15:00 on the in-patient visit day randomly assigned each subject for exercise; ends at start of the subsequent meal. Median period: 121 minutes (min), interquartile range (IQR): 15 min, range: 93 to 133 min.
The PG nadir observed following the start of exercise
Begins at start of exercise, at or after 15:00 on the in-patient visit day randomly assigned each subject for exercise; ends at start of the subsequent meal. Median period: 121 minutes (min), interquartile range (IQR): 15 min, range: 93 to 133 min.
Overnight Nadir Plasma Glucose (PG)
기간: Union of the two 8-hour overnight periods beginning at 22:00 on in-patient visit days 2 & 3, ending at 6:00 on the subsequent day. The union of the two periods was 960 minutes (min) for all subjects, both study phases.
For each subject and study phase, the overnight nadir PG for each of two nights were determined. The mean of these two nadirs became the one nadir overnight PG value representing each subject and study phase.
Union of the two 8-hour overnight periods beginning at 22:00 on in-patient visit days 2 & 3, ending at 6:00 on the subsequent day. The union of the two periods was 960 minutes (min) for all subjects, both study phases.
Percentage of Time Plasma Glucose (PG) is Within the Euglycemic Range.
기간: Begins at 6:00 of in-patient visit day 2 and ends at 6:00 of day 4; 48 hours total.
For each subject and arm, the percentage of the PG curve such that 70 <= PG curve <= 180 mg/dL. Linear interpolations furnished the data between the actual sampled PG to address potential sample influence bias arising from non-uniform sampling intervals.
Begins at 6:00 of in-patient visit day 2 and ends at 6:00 of day 4; 48 hours total.
Percentage of Time Plasma Glucose (PG) is Above the Euglycemic Range.
기간: Begins at 6:00 of in-patient visit day 2 and ends at 6:00 of day 4; 48 hours total.
For each subject and study phase, the percentage of the PG curve > 180 mg/dL. Linear interpolations furnished the data between the actual sampled PG to address potential sample influence bias arising from non-uniform sampling intervals.
Begins at 6:00 of in-patient visit day 2 and ends at 6:00 of day 4; 48 hours total.
Percentage of Time Plasma Glucose (PG) is Below the Euglycemic Range.
기간: Begins at 6:00 of in-patient visit day 2 and ends at 6:00 of day 4; 48 hours total.
For each subject and study phase, the percentage of the PG curve < 70 mg/dL. Linear interpolations furnished the data between the actual sampled PG to address potential sample influence bias arising from non-uniform sampling intervals.
Begins at 6:00 of in-patient visit day 2 and ends at 6:00 of day 4; 48 hours total.

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

스폰서

수사관

  • 수석 연구원: Stuart Weinzimer, MD, Yale University

간행물 및 유용한 링크

연구에 대한 정보 입력을 담당하는 사람이 자발적으로 이러한 간행물을 제공합니다. 이것은 연구와 관련된 모든 것에 관한 것일 수 있습니다.

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작

2009년 1월 1일

기본 완료 (실제)

2010년 11월 1일

연구 완료 (실제)

2010년 11월 1일

연구 등록 날짜

최초 제출

2009년 1월 26일

QC 기준을 충족하는 최초 제출

2009년 1월 26일

처음 게시됨 (추정)

2009년 1월 28일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2017년 12월 12일

QC 기준을 충족하는 마지막 업데이트 제출

2017년 11월 9일

마지막으로 확인됨

2017년 11월 1일

추가 정보

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아니요

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1형 당뇨병에 대한 임상 시험

Closed Loop에 대한 임상 시험

3
구독하다