Single Arm Intervention Trial of DEKA TWIIST TM Insulin Pump Utilizing Tidepool Loop Algorithm in Pregnant People With Pre-existing Type 1 Diabetes
Studie Overzicht
Toestand
Toestand
Conditie
Conditie
Interventie / Behandeling
Interventie / Behandeling
Studietype
Studietype
Inschrijving (Geschat)
Inschrijving
Fase
Fase
- Niet toepasbaar
Contacten en locaties
Studiecontact
Studiecontact
- Naam: Chloe Miller, BS
- Telefoonnummer: 507-255-0316
- E-mail: miller.Chloe4@mayo.edu
Studie Locaties
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California
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Stanford, California, Verenigde Staten, 94305
- Stanford University
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Contact:
- Rayhan Lal, MD
- Telefoonnummer: 8139758690
- E-mail: ppwt1d@jaeb.org
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Colorado
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Aurora, Colorado, Verenigde Staten, 80045
- University of Colorado, Anschutz Medical Campus
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Contact:
- Sarit Polsky, MC
- Telefoonnummer: 8139758690
- E-mail: ppwt1d@jaeb.org
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Minnesota
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Rochester, Minnesota, Verenigde Staten, 55905
- Mayo Clinic
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New York
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New York, New York, Verenigde Staten, 10029
- Icahn School of Medicine at Mount Sinai
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Contact:
- Carol Levy, MD
- Telefoonnummer: 8139758690
- E-mail: ppwt1d@jaeb.org
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Deelname Criteria
Geschiktheidscriteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
Accepteert gezonde vrijwilligers
Beschrijving
Inclusion Criteria:
- Singleton pregnancy is confirmed by ultrasound.
- Pregnant woman between pregnancy confirmation to 96/7 weeks gestation.
- Clinical diagnosis of T1D for 1 year or longer.
- Using insulin pump (AID/SAP) or multiple daily insulin injections at screening visit.
- Willing to use U100 aspart (Novolog) or lispro (Humalog) insulin during the study.
- Willing to announce all carbohydrate intake unless for the treatment or prevention of hypoglycemia.
- No significant maternal and/or fetal complications at the time of enrollment visit.
- Willing to abide by study protocol.
- Willing to learn and use study-provided devices and perform necessary actions for interacting with devices when needed.
- Able and willing to receive routine and specialty obstetric care during the study.
- Able to speak and understand English and provide informed consent.
- Able to have at least one care partner available during the study. A care partner is defined as an adult person (≥18 yrs.) who will either be staying in the same location as the participant or within a 40-mile radius and willing to be trained on study devices and using the TWIIST smartphone App (follower app), will to provide treatment of hypo- and hyperglycemia, and able to take the participant to the hospital or call 911 (emergency services) in case of an emergency.
Exclusion Criteria:
- Individuals with T2D, gestational diabetes, or other types of diabetes (e.g., CFRD, MODY, etc.).
- Use of basal insulin alone.
- Use of short-acting insulin alone, unless use is through an insulin pump.
- Severe allergy to medical grade adhesives within the last 3 months that would inhibit participant ability to wear the study devices.
- Significant maternal and/or fetal complications, such as pre-existing heart disease (untreated or unstable cardiac diseases), pre-existing severe kidney (eGFR < 45) disease and any other condition that limits participant safety as per investigator discretion.
- Unwilling to wear the study insulin pump for the duration of the study or unwilling to switch from current insulin therapy to investigational device for duration of the study.
- Presence of significant skin diseases/changes at sensor or infusion wear sites (for example: extensive scarring, extensive eczema, dermatitis herpetiformis, extensive burn or extensive psoriasis).
- Multifetal pregnancy.
- Inadequate access to a phone and/or computer (for downloading devices and web-based communications).
- Unable to attend required on-site study visits due to a planned move to a non-commutable distance to the study site.
- People with advanced diabetes complications such as advanced nephropathy (creatinine >1.5 mg/dl, eGFR <45 or currently on dialysis), severe autonomic neuropathy, uncontrolled gastroparesis, advanced retinopathy requiring active treatments or as per investigator judgment.
- Any bleeding disorder or hemophilia.
- Abnormal TSH 6 weeks after two consecutive titrations of thyroid medications
- Adrenal insufficiency.
- History of severe hypoglycemic event or DKA requiring hospitalization in the past 3 months or greater than 1 episode of DKA within the last year.
- Currently being treated for malignancies.
- Organ transplant recipient.
- On ultra rapid acting insulin, inhaled insulin or U200 insulin unless willing to switch to an insulin with existing data on pump compatibility.
- Daily insulin dose ≥ 1.5 units/kg/day at enrollment.
- Current use of any non-insulin glucose lowering agents except metformin, unless willing to discontinue use of said agents to participate in the study.
- Chronic oral steroid use, current oral steroid use, or high dose steroid use (oral or injectable) in the last 2 months.
- Body mass index > 40 kg/m2 at enrollment.
- Known or suspected allergy to insulin.
- Severe visual or hearing impairment preventing successful use of study system.
- Participant has any condition (physical or psychological disease) that in the opinion of the site investigator would interfere with the normal conduct and interpretation of the study results or put participant at risk during the study.
- Currently participating in another pharmaceutical or device related interventional trial at the time of enrollment or any time during the study.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: NVT
- Interventioneel model: Opdracht voor een enkele groep
- Masker: Geen (open label)
Aantal wapens
Wapens en interventies
Deelnemersgroep / ArmDeelnemersgroep / Arm |
Interventie / BehandelingInterventie / Behandeling |
|---|---|
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Experimenteel: AID and CGM
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The AID control algorithm, that will be used during the study employs a model-based predictive control algorithm to forecast future glucose levels.
This predictive model accounts for the impact of delivered insulin, user-entered carbohydrates, and incorporates two short-term adaptations: "glucose momentum" and "retrospective correction."
These features work to optimize glucose management with precision.
The impact of carbohydrates is calculated based on the user-defined insulin-to-carbohydrate ratio and insulin sensitivity factor (ISF), while the insulin effect is governed by the ISF itself.
The system then dynamically adjusts insulin delivery, aiming to bring glucose levels in line with the midpoint of the user's personalized glucose target range.
Loop fine-tunes insulin delivery by increasing or decreasing the basal insulin rate, as needed, each time a new CGM value is received.
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Wat meet het onderzoek?
Primaire uitkomstmaten
Primaire uitkomstmaten
Uitkomstmaat |
Tijdsspanne |
|---|---|
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Time in Range 60-140 mg/dL per night
Tijdsspanne: 30 weeks
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30 weeks
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Medewerkers en onderzoekers
Sponsor
Sponsor
Medewerkers
Medewerkers
Onderzoekers
Onderzoekers
- Hoofdonderzoeker: Yogish C. Kudva, MBBS, Mayo Clinic
Studie record data
Bestudeer belangrijke data
Studie start (Geschat)
Studie start
Primaire voltooiing (Geschat)
Primaire voltooiing
Studie voltooiing (Geschat)
Studie voltooiing
Studieregistratiedata
Eerst ingediend
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Eerst geplaatst
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update geplaatst
Laatste update ingediend die voldeed aan QC-criteria
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
Andere studie-ID-nummers
- 25-011927
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
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