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Effect of Liraglutide on Automated Closed-loop Glucose Control in Type 1 Diabetes

28. januar 2020 oppdatert av: Jennifer Sherr
"Closed loop artificial pancreas" systems have been under development for the control of blood sugars in those living with diabetes. These systems consist of a continuous glucose sensor, which sends a signal to a computer program that automatically determines how much insulin to give. The computer program then tells an insulin pump to deliver the insulin. While such systems have been tested under a number of conditions, post-meal blood sugars are difficult to control. This study is designed to see if liraglutide, a glucagon like peptide receptor agonist, can help minimize the post meal blood sugar spikes in subjects with type 1 diabetes while they are on a closed loop system.

Studieoversikt

Status

Fullført

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

Open-label, crossover study comparing the peak post-prandial glucose levels and the incremental post-prandial glucose area under the curve (AUC) during closed loop (CL) control alone and during CL control with liraglutide in an inpatient research setting. Data generated during outpatient baseline evaluation and liraglutide dose titration phases of the study will be compared to assess the short-term efficacy of this agent during open-loop continuous subcutaneous insulin infusion (CSII) pump treatment.

Studietype

Intervensjonell

Registrering (Faktiske)

15

Fase

  • Tidlig fase 1

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Forente stater
    • Connecticut
      • New Haven, Connecticut, Forente stater, 06520
        • Yale University School of Medicine

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år til 40 år (Voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

  1. age 18-40 years
  2. clinical diagnosis of Type 1 diabetes (T1D) (formal antibody and/or genetic testing will not be required)
  3. duration of T1D ≥ 1 year
  4. HbA1c ≤ 9 %
  5. Treated with CSII for at least 3 months
  6. Body weight > 50 kg (to accommodate phlebotomy)
  7. Be in good general health without other medical or psychiatric illnesses that would, in the judgment of the investigator, interfere with subject safety or study conduct

Exclusion Criteria:

  1. Insulin resistant (defined as requiring > 1.5 units/kg/day at time of study enrollment)
  2. Presence of any medical or psychiatric disorder that may interfere with subject safety or study conduct
  3. Use of any medications (besides insulin) known to blood glucose levels, including oral or other systemic glucocorticoid therapy. Inhaled, intranasal, or rectal corticosteroid use is allowed along as not given within 4 weeks of admission to the hospital research unit (HRU). Use of topical glucocorticoids is allowable as long as affected skin area does not overlap with study device sites. Subjects using herbal supplements will be excluded, due to the unknown effects of these supplements on glucose control
  4. History of hypoglycemic seizure within last 3 months
  5. Anemic (low hematocrit), evidence of renal insufficiency (elevated serum creatinine, BUN) or elevated liver function tests.
  6. Female subjects who are pregnant, lactating, or unwilling to be tested for pregnancy
  7. History of celiac disease gastroparesis, gastroesophageal reflux disease (GERD), disorder of gastric emptying, or disorder of intestinal motility
  8. Taking a medication known to affect gastric motility
  9. History of pancreatitis, gallstones, alcoholism or high triglyceride levels
  10. Personal or family history of thyroid cancer or multiple endocrine neoplasia type 2 (MEN2)
  11. Subjects unable to give consent

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Intervensjonsmodell: Enkeltgruppeoppdrag
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Closed Loop Insulin Delivery

Each participant recruited into the study will undergo two inpatient closed loop admissions.

The first admission will be utilizing closed loop control alone, using the Medtronic external Physiological Insulin Delivery (ePID) algorithm. The ePID controller uses a proportional-integral-derivative algorithm modified to include insulin feedback.

Following the first closed loop admission, each participant is initiated on adjunctive once daily liraglutide therapy. They undergo a 3-4 week dose titration period.

Participants are then admitted for a second closed loop admission to assess the combined effects of closed loop control with adjunctive once daily liraglutide therapy.
Enhet: ePID lukket sløyfesystem
Insulinpumpe styrt av lukket sløyfeenhet og algoritme
Legemiddel: liraglutide
Liraglutide is a long-acting analog of human glucagon like peptide-1 (GLP-1) that works as a GLP-1 receptor agonist
Andre navn:
  • Victoza

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Peak Post-prandial Venous Glucose Levels
Tidsramme: 48 hours
peak post-prandial venous glucose levels obtained after breakfast, lunch, and dinner between closed loop (CL) alone and CL + liraglutide
48 hours

Sekundære resultatmål

Resultatmål
Tidsramme
the Incremental Meal-related Glucose Area Under Curve (AUC)
Tidsramme: 5-hour post prandial period after breakfast, lunch, and dinner
5-hour post prandial period after breakfast, lunch, and dinner

Andre resultatmål

Resultatmål
Tidsramme
Mean 24-hour Glucose Levels
Tidsramme: 24- hours
24- hours
Mean Time to Peak Post-meal Glucose Value
Tidsramme: 5- hour postprandial period
5- hour postprandial period
Mean Daytime Glucose Levels
Tidsramme: 8a.m.-11p.m.
8a.m.-11p.m.
Incremental Glucagon Peak
Tidsramme: 5 hours
5 hours
AUC Plasma Glucagon During MMTT
Tidsramme: 2 hours
2 hours
Differences in Daily Insulin Requirements
Tidsramme: 24 hours
24 hours
Prandial Insulin Delivery During Closed Loop Therapy
Tidsramme: Average of the 5-hour post prandial period for breakfast, lunch, dinner combined
Average of the 5-hour post prandial period for breakfast, lunch, dinner combined
Mean Nocturnal Glucose Levels
Tidsramme: 11p.m.-6a.m.
11p.m.-6a.m.

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Jennifer Sherr

Samarbeidspartnere

Yale University
Juvenile Diabetes Research Foundation

Etterforskere

  • Hovedetterforsker: Jennifer Sherr, MD, PhD, Yale University

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. februar 2013

Primær fullføring (Faktiske)

1. november 2015

Studiet fullført (Faktiske)

1. november 2015

Datoer for studieregistrering

Først innsendt

14. mai 2013

Først innsendt som oppfylte QC-kriteriene

14. mai 2013

Først lagt ut (Anslag)

17. mai 2013

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

30. januar 2020

Siste oppdatering sendt inn som oppfylte QC-kriteriene

28. januar 2020

Sist bekreftet

1. januar 2020

Mer informasjon

Begreper knyttet til denne studien

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • 1211011156

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

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