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Feasibility and Safety Study of the Automated Insulin Delivery Closed Loop System Pancreas4ALL (ASAP)

2021년 4월 4일 업데이트: Lenka Petruzelkova

Feasibility Study of the Pancreas4ALL Closed-loop Automated Glycemic Control System in Patients With Type 1 Diabetes Mellitus: Pancreas4ALL Project - Good News Study - Phase I

Pilot prospective controlled monocentric open-label, randomized study evaluating the feasibility and safety of the Pancreas4All automated "closed loop" glycemic control system.

연구 개요

상태

모병

정황

개입 / 치료

상세 설명

  1. Screening - day 0
  2. Hospitalization (Day 1-10) Day 1 - Deployment of study equipment, patient education Day 2 - Start of study, activation of Pancreas4ALL closed loop in mode - hybrid closed loop (2.7.1) Day 4 - Randomization of patients to Group A and to Group B Group A - Activation of Pancreas4ALL closed loop in closed loop mode - "food announcement" (2.7.2) Group B - Activation of Pancreas4ALL closed loop in mode - full closed loop mode (2.7.3) Day 7 - Crossover - Group exchange Day 10 - Return to the initial treatment modality.
  3. Termination of the study

Detailed description of the clinical trial - study control plan:

Outpatient check:

  1. Signing of informed consents to the study and GDPR consent to the processing of personal data by the legal representative and the entity that will be included in the study
  2. Urine pregnancy test for women and girls after menarche
  3. Blood collection for the determination of HbA1c, TSH and creatinine
  4. Evaluation of entry criteria (inclusion criteria); if all criteria are met, the subject will be included in the study.

Day 1:

  1. Hospitalization in the inpatient part of the University Hospital and the 2nd Medical Faculty of Charles University, Department of Endocrinology and Diabetology.
  2. Download data from an existing pump / sensor for the last 3 months to Carelink or Diasend
  3. Creating a DexCom Clarity and Diasend / Tidepool account (certified patient data store)
  4. Training of the patient in the use of the DANA RS Diabcare pump and the DexCom G6 CGM
  5. Training of Samsung S10e mobile phone with active version of Pancreas4ALL application connected to Dana RS Diabcare and Dexcom G6 IP - mode open loop
  6. Application of DANA RS Diabcare insulin pump and CGM Dexcom G6 to the patients
  7. Optimization of basal dose and bolus calculator settings using Pancreas4ALL advisor (calculation based on patient's age, weight and CDD)
  8. Education about the necessary inputs (data entered by the patient) into the Pancreas4ALL application.
  9. Activation of the Pancreas4ALL application - open loop. Preprandial bolus calculated by the patient using a bolus calculator, part of the Pancreas4ALL application.
  10. Completion of the Quality of Life (QoL) Questionnaire PedsQl

Defined Pancreas4ALL settings for all subjects.

  • Target glycemia 5.5 mmol / mol
  • Active insulin time 6 hours
  • Setting automatic functions: In case of hypoglycemia (glycemia below 3.9 mmol / l), a temporary blood glucose target of 8 mmol / l is automatically set for 30 minutes after the hypoglycemia has occurred.

Another activities:

  • In case of physical activity, it is recommended that the patient temporarily increase the target glycemia to 8 mmol / l, switch to a temporary profile of 70-80% depending on the intensity of physical activity (automatic recalculation of basal dose, insulin sensitivity, insulin carbohydrate ratio to 70-80%)
  • In case of illness accompanied by an increase in glycaemia, the patient is recommended to switch to a temporary profile of 120-150% (automatic recalculation of the basal dose, insulin sensitivity, insulin carbohydrate ratio at the set 120-150%)

Day 2:

1) Initiation - activation of the "closed loop" Pancreas4All in the hybrid closed loop mode (2.7.1)

  1. The patient will enter the number of carbohydrates eaten into the application, using the bolus calculator to calculate the preprandial bolus.
  2. Meal blood glucose will be corrected using the Pancreas4All automated system.
  3. In case of glycemia above 13 mmol / l 30 min after a meal, the correction bolus will be calculated using a bolus calculator. Hyperglycemia management see appendix.
  4. In case of hypoglycaemia (glycaemia <3.9 mmol /), the subject will be given dextrose in the form of tablets or a sweet drink (the amount of dextrose will be calculated according to the patient's weight, current level and glycemic trend) See Appendix.

Day 4:

  1. Randomization to group A and group B
  2. Randomization will be performed using an IT application according to age, gender, weight and input glycated hemoglobin.

  3. Randomization:

    1. Group A: Activation of Pancreas4ALL in closed loop mode in "meal announcement" (version 2.7.2). The patient will only enter a notification in the application that he is going to eat.
    2. Group B: Activation of the Pancreas4ALL application in mode full closed loop mode (version 2.7.3). The subject will not enter any notification or notification into the application that it is going to eat.
  4. Other settings + glycemic control remain as in the previous phase.

Day 7 - Cross-over - change of settings for groups A and B:

  1. The basic settings remain unchanged
  2. Change the setting mode in groups A and B
  3. Blood glucose control see above.

Day 10 - Visit 2 - End of study:

  1. Download data from pump to DexCom clarity and Diasend / Tidepool, check data storage from IP and sensor
  2. Evaluation of glycemic control for the last week
  3. Completion of the PedsQl Quality of Life (QoL) Questionnaire + System Satisfaction Questionnaire.
  4. Termination of the study - return to the standard treatment modality of the patients

연구 유형

중재적

등록 (예상)

16

단계

  • 해당 없음

연락처 및 위치

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

연구 연락처

연구 연락처 백업

연구 장소

  • 체코
      • Prague, 체코, 15006
        • 모병
        • Department of Paediatrics, Motol University Hospital 2nd Medical Faculty in Prague, Charles University
        • 연락하다:

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

15년 (어린이, 성인)

건강한 자원 봉사자를 받아들입니다

아니

연구 대상 성별

모두

설명

Inclusion Criteria:

Subjects will be included in the study if they meet the following entry criteria:

  1. The subject was diagnosed with type 1 DM ≥ 1 year
  2. The subject is aged 15-25
  3. The subject has an HbA1C value between 43 mmol / mol and 75 mmol / mol at the time of the screening visit
  4. The subject must have experience with insulin pump therapy and CGM ≥ 3 months
  5. The subject is willing to use the system Pancreas4ALL continuously throughout the study

Exclusion Criteria:

1. The subject does not tolerate the adhesive patch at the sensor site for CGM 2. Women of productive age who have a positive pregnance test at the time of screening or are planning to become pregnant at the time of the study 4. The subject underwent the following diagnoses in the year preceding screening: myocardial infarction, unstable angina pectoris, coronary artery bypass passage, stent insertion into the coronary artery, transient ischemic attack, cerebrovascular accident, angina pectoris, congestive heart failure, ventricular arrhythmia or thromboembolism 5. The subject has an abnormal (> 1.5x times the upper reference limit, as assessed by the laboratory) creatinine at the time of screening 6. The subject has clinically significant abnormalities (outside the reference range as assessed by the laboratory) of thyroid stimulating hormone (TSH) at the time of screening 7. The subject has taken any oral or injectable corticosteroids in the last 8 weeks prior to the screening visit, or plans to take any oral or injectable corticosteroids during the study 8. The subject is actively involved in any research study (drug or instrumental) in which he or she has undergone treatment with a research drug or research facility in the previous 2 weeks prior to the screening visit.

9. The subject is currently using illicit drugs 10. The subject is currently abusing prescription drugs 11. The subject is currently addicted to alcohol 12. The subject is taking pramlintide (Symlin) or an SGLT2 inhibitor at the time of the screening visit 13. The subject suffers from a visual impairment that does not allow him to participate in the study and to safely perform all tasks within the study, as determined by the investigator 14. The subject has planned elective surgery requiring general anesthesia for the duration of the study 15. The subject has currently been diagnosed with an eating disorder such as anorexia or bulimia 16. The subject has been diagnosed with chronic renal failure leading to chronic anemia 17. The subject is dialyzed

공부 계획

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

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 장치 타당성
  • 할당: 무작위
  • 중재 모델: 크로스오버 할당
  • 마스킹: 없음(오픈 라벨)

무기와 개입

참가자 그룹 / 팔
개입 / 치료
간섭 없음: Hybrid closed loop group
Patients using AID system Pancreas4ALL in mode hybrid closed loop.
실험적: Closed loop meal announcment
Patients using AID system Pancreas4ALL in mode meal announcment. They only announce what amout of carbs going to eat. They calculate no bolus
장치: Pancreas4ALL - meal announcement or full closed loop
Patient using AID Pancreas4ALL in mode meal announcment or full closed loop.
실험적: Full closed loop
Patients using AID system Pancreas4ALL in mode full closed loop. They eating with no permission and they do not calculate and sending bolus anymore.
장치: Pancreas4ALL - meal announcement or full closed loop
Patient using AID Pancreas4ALL in mode meal announcment or full closed loop.

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
The feasibility of the prototype device Pancreas4ALL
기간: ten days
Percentage of time of automatic control of glucose by Pancreas4ALL would be > 90%
ten days
The safety of the prototype device Pancreas4ALL
기간: ten days
Percentage of time spent in hypoglycemia 2.degrees (<3 mmol / L) would be < 1% during sutomatic glucose control by Pancreas4ALL
ten days

2차 결과 측정

결과 측정
측정값 설명
기간
GCM parametrs of glycemic control
기간: ten days
Calculation of Time in range (3.9 - 10 mmol / l) which would be > 75% throughout the study Translation results "The secondary goal is excellent glycemic control in all tested versions of the Pancreas4ALL closed loop application (version 2.7.1, version 2.7.2, version 2.7.3), defined as the time spent in Time in range (3.9 - 10 mmol / l) > 70% throughout the study. "
ten days
Quality of life of patient living on closed loop system Pancreas4ALL
기간: seven days
PedsQL Diabetes Module 3.2 - questionnaire
seven days

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

스폰서

Lenka Petruzelkova

협력자

CLOSED LOOP Systems s.r.o.

수사관

  • 수석 연구원: Lenka Petruzelkova, MD, PhD, Department of Paediatrics, Motol University Hospital, Charles University

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)

2021년 2월 19일

기본 완료 (예상)

2021년 4월 30일

연구 완료 (예상)

2021년 5월 1일

연구 등록 날짜

최초 제출

2021년 3월 23일

QC 기준을 충족하는 최초 제출

2021년 4월 4일

처음 게시됨 (실제)

2021년 4월 8일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2021년 4월 8일

QC 기준을 충족하는 마지막 업데이트 제출

2021년 4월 4일

마지막으로 확인됨

2021년 4월 1일

추가 정보

이 연구와 관련된 용어

키워드

추가 관련 MeSH 약관

기타 연구 ID 번호

  • 01-CIP-27-11-20

개별 참가자 데이터(IPD) 계획

개별 참가자 데이터(IPD)를 공유할 계획입니까?

예

IPD 계획 설명

basic characteristic of participants and all results

IPD 공유 기간

3 months

IPD 공유 지원 정보 유형

  • 연구_프로토콜
  • 수액
  • ICF
  • CSR

약물 및 장치 정보, 연구 문서

미국 FDA 규제 의약품 연구

아니

미국 FDA 규제 기기 제품 연구

아니

미국에서 제조되어 미국에서 수출되는 제품

아니

이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .

구독하다