Comparison of an Artificial Pancreas Versus Threshold Low Glucose Suspend in Type 1 Diabetic Children (SHAN)
2018년 6월 12일 업데이트: University Hospital, Montpellier
Assessment of the Efficacy on the Reduction of Nocturnal Hypoglycemia in Children With Type 1 Diabetes of a Closed-loop Insulin Therapy (Artificial Pancreas) Compared to Insulin Pump Therapy Combined With Continuous Glucose Monitoring With Threshold Low Glucose Suspend of Infusion in Home-like Conditions
The objective of this study is to assess the efficacy of an Artificial Pancreas system which includes a Control-To-Range algorithm, versus standard Insulin Pump Therapy with Threshold Low glucose Suspend feature.
24 Children aged from 7 to 12 will be recruted in 4 clinical centres.
After a 2 week run-in period, they will attend two investigational sessions of 65 hours in home-like settings.
During each session, the CTR algorithm or the TLGS feature will be activated, depending on the randomization.
The main endpoint is the time spent below 70mg/dL between 22:00 and 07:00.
연구 개요
상태
완전한
정황
상세 설명
The study is an open randomized control trial preceded by a run-in period and follows a cross-over design.After inclusion, the therapy will be moved to sensor augmented pump therapy with a dedicated training to continuous glucose monitoring using study system (study CGM).
During 2 to 3 weeks, the patient will use his/her usual insulin pump and the study CGM (run-in period).
At the end of this period, the patient and the relative will be admitted in a parents'house or hotel/resort nearby the hospital for 65 hours to undergo the first interventional session.
Admission will be at 17:00 Day 1.
The investigator will connect wirelessly the study pump and CGM to the study platform DiAs and remote monitoring will be activated.
Until 08:00 Day 2, insulin delivery will be managed in open-loop mode, i.e. insulin doses will be decided according to capillary glucose measurements.
From 08:00 Day 2, one algorithm will be activated according to the randomization order, i.e. either the threshold low glucose suspend (TLGS) algorithm (threshold will be set at 70 mg/dl) or the closed-loop algorithm.
Insulin delivery will then be managed in open-loop mode with activated TLGS or by the closed-loop algorithm until 08:00 Day 4. In both cases, meals will be of free content and taken around 09:00, 13:00, 17:00 and 20:00.
Meal insulin doses will be managed according to pre-meal glucose level and CHO meal content in open-loop mode with TLGS, or according to DiAs bolus calculator suggestion in closed-loop mode.
Patient and relative will be encouraged to move in parents'house or hotel/resort and surroundings between meals.
The algorithm will be inactivated at 08:00 Day 4. The study pump will be removed and replaced by patient's usual pump.
The patient and the relative will be released at 10:00 after breakfast.
Study CGM will still be used at home for 2 to 4 weeks until the second interventional session.
This session will be similar to the first one but the alternative algorithm will be activated.
Patient will come back to pre-study insulin therapy from 08:00 Day 4 and be released at 10:00 when second session is completed.
연구 유형
중재적
등록 (실제)
24
단계
- 2 단계
연락처 및 위치
이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.
연구 장소
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Angers, 프랑스, 49000
- CHU d'Angers
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Montpellier, 프랑스, 34985
- CHU Montpellier - Hôpital Lapeyronie
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Paris, 프랑스, 75019
- AP-HP, Hôpital Robert Debré
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Tours, 프랑스, 37000
- CHU de Tours, Hôpital Clocheville
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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
7년 (어린이)
건강한 자원 봉사자를 받아들입니다
아니
연구 대상 성별
모두
설명
Inclusion Criteria:
- Age from 7 to 12
- Puberty status at Prader 1
- Diabetes diagnosed according to WHO criteria since more than 1 year
- Fasting plasma C-peptide level <0.2 ng/ml for a fasting blood glucose level < 180 mg/dl
- At least one positiveness for plasma antibodies against pancreatic islets: IAA, IA2, GAD, ICA or ZnT8, since diagnosis of diabetes
- Treatment of diabetes by insulin pump since more than 6 months
- HbA1c level below 8.5%
- Trained in carbohydrate counting
- Lack of any associated disease or therapy (except insulin) affecting glucose metabolism
- Willingness to follow all study procedures
- Informed consent signed by patient and parent or legally responsible party
- Patient must be affiliated or beneficiary of a social medical insurance
Exclusion Criteria:
- Unwillingness of one parent or the legally responsible party to be present during all study procedures
- Expected use of acetaminophen-containing drugs
- Any disease or therapy (except insulin) affecting glucose metabolism during previous month
- Impaired cognitive or psychological abilities which may result in defective adherence to study procedures
- Active enrollment in another clinical trial or participation in a study within 30 days or participation in previous studies resulting in a cumulated annual income which would exceed 4500 €
공부 계획
이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 할당: 무작위
- 중재 모델: 크로스오버 할당
- 마스킹: 없음(오픈 라벨)
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
|---|---|
|
실험적: Control-to-Range algorithm and Threshold Low Glucose Suspend
On this arm, patients will realize two investigational sessions:
|
The insuline used is usual patient insuline.
There is no specific insulin for this protocol
The insuline used is usual patient insuline.
There is no specific insulin for this protocol
|
|
실험적: Threshold Low Glucose Suspend and Control-to-Range algorithm
On this arm, patients will realize two investigational sessions:
|
The insuline used is usual patient insuline.
There is no specific insulin for this protocol
The insuline used is usual patient insuline.
There is no specific insulin for this protocol
|
연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
기간 |
|---|---|
|
Time spent with blood glucose <70 mg/dl
기간: from 22:00 to 08:00, over two consecutive nights
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from 22:00 to 08:00, over two consecutive nights
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2차 결과 측정
결과 측정 |
기간 |
|---|---|
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Percent time spent with blood glucose <70mg/dl
기간: over two consecutive days (48h)
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over two consecutive days (48h)
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Percent time spent with blood glucose level in 70-180 mg/dl range
기간: from 22:00 to 08:00 over two consecutive nights
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from 22:00 to 08:00 over two consecutive nights
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Percent time spent with blood glucose level in 80-150 mg/dl range
기간: from 22:00 to 08:00 over two consecutive nights
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from 22:00 to 08:00 over two consecutive nights
|
|
Percent time spent with blood glucose level in 70-180 mg/dl range
기간: over two consecutive days (48h)
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over two consecutive days (48h)
|
|
Mean blood glucose level
기간: from 22:00 to 08:00, over two consecutive nights
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from 22:00 to 08:00, over two consecutive nights
|
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Mean blood glucose level
기간: over two consecutive days (48h)
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over two consecutive days (48h)
|
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Number of needed interventions by the patients, the parents, and by the investigational team, to treat hypoglycemia
기간: during 65 hours of each investigational session
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during 65 hours of each investigational session
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Number of needed interventions by the patients, the parents, and by the investigational team, to fix issues related to the functioning of the insulin delivery system
기간: during 65 hours of each investigational session
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during 65 hours of each investigational session
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Score of the Artificial Pancreas Acceptance Questionnaire
기간: at time of inclusion (at Visit 2) and 5 to 6 weeks after inclusion (i.e at Visit 4)
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at time of inclusion (at Visit 2) and 5 to 6 weeks after inclusion (i.e at Visit 4)
|
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Score of the Hypo Fear Survey
기간: at time of inclusion (at Visit 2) and 5 to 6 weeks after inclusion (i.e at Visit 4)
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at time of inclusion (at Visit 2) and 5 to 6 weeks after inclusion (i.e at Visit 4)
|
공동 작업자 및 조사자
여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.
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 (실제)
2015년 6월 16일
기본 완료 (실제)
2016년 12월 1일
연구 완료 (실제)
2016년 12월 1일
연구 등록 날짜
최초 제출
2015년 7월 8일
QC 기준을 충족하는 최초 제출
2015년 7월 23일
처음 게시됨 (추정)
2015년 7월 28일
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
2018년 6월 14일
QC 기준을 충족하는 마지막 업데이트 제출
2018년 6월 12일
마지막으로 확인됨
2015년 7월 1일
추가 정보
이 연구와 관련된 용어
키워드
추가 관련 MeSH 약관
기타 연구 ID 번호
- 9525 (기타 식별자: CTEP)
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