Initial Testing of the Diabeloop Algorithm in T1D Patients on Pump Therapy Over the Prandial Period and Physical Activity. (DiabeloopWP6-0)
Development of the Glycemic Control Algorithm, in Prandial and Physical Effort Situations.
The main objective is to assess if the Diabeloop algorithm provides better glycemic control than a "manual" usual algorithm of patients with type 1 diabetes treated by insulin pump during meals, and during activity qualified "moderate" to "severe" by the patients.
The study will be conducted in 18 patients. The investigation centers are: CHSF (for Diabeloop algorithm test during activity), CHU of Grenoble and CHU of Toulouse (for Diabeloop algorithm test during meals.
研究概览
详细说明
Grenoble and Toulouse will test the prandial algorithm with several carbohydrate intake and a primer of 50% or 75% of the total bolus. Groups of patients are described as follows:
- Group I: patients have a meal with the usual carbohydrate intake. The meal bolus is made according to the current treatment.
- Group II: patients have a meal with a "low" carbohydrate intake (50% reduction of carbohydrate).
- Group III: patients have a meal with a "strong" carbohydrate intake (increase 50% of carbohydrate).
- Group IV: patients of group IV have each meal with carbohydrate intake but their usual bolus will be omitted.
- Inclusion visit V1: The study will be proposed at the patients who meet the inclusion criteria. After signing the consent, the investigator shall designate one group for each patient.
- Visit V2 (24 hours before the visit V3): Installation, calibration and education of two glucose sensors dexcom G4 ™ will be performed by a nurse. The patient will keep two sensors until the end of the study (end of V4).
- Visit V3 (algorithm test): Patient will be fitted with its insulin pump and the two sensors dexcom G4 ™. These will be coupled by the engineer LETI to the computer on which is installed the control algorithm to be tested. Lunch will be taken at 1 pm. The algorithm will provide proposals insulin every 15 minutes until 6 pm.
- Visit V4 (patient control): Patient will be fitted with two sensors dexcom G4 ™ and its insulin pump programmed according to the usual algorithm. The meal will be taken at 1h PM. Patient can leave the site at 6 pm after removal of sensors.
CHSF (Centre Hospitalier Sud Francilien) will test the algorithm glycemic control during physical activity of moderate (50% VO2max) or high intensity (75% VO2max) for 30 minutes on a bicycle ergometer. In different situations, three patient groups will be created:
- Group A: Patients practice an "average" physical activity(50% VO2max) with usual temporary basal reduction (usually 50% of reduction during the test and 2h next).
- Group B: Patients practice an "intense" physical activity (75% VO2max) with usual temporary basal reduction (usually 80% of reduction during the test and 2h after).
- Group C: patients practice an "average" physical activity (50% VO2max) but without concomitant reduction of temporary basal.
- Inclusion visit V1 : The study will be proposed at the patients who meet the inclusion criteria. After signing the consent, the investigator shall designate one group for each patient.
- Visit V2 : Patient will be equipped with two sensors dexcom G4 ™ and a heart rate monitor. Calibrated meal is expected at 11h 30 pm. The patient will be administered his insulin dose according to his usual algorithm. The physical test will begin three hours after the meal. It will be carried on bicycle ergometer for 30 minutes at an medium or high intensity. (Average = 50% VO2max, or high level = 75% VO2max).
- Visit V3: The same test is repeated for each patient during this visit. Its insulin pump will be controlled by the doses proposal of the algorithm after manual validation by the investigator. These will continue until the next morning, and the patient will spend overnight in the hospital.
研究类型
注册 (实际的)
阶段
- 第三阶段
联系人和位置
学习地点
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-
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Evry、法国、91058
- Centre Hospitalier Sud Francilien
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Grenoble、法国、38043
- University Hospital of Grenoble
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Toulouse、法国、31403
- University Hospital of Toulouse
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
Inclusion Criteria:
- Patients with type 1 diabetes treated by external insulin pump;
- Patients with HbA1c <8.5%.
- Patients aged 18 years or less;
- Patient who signed consent;
- Patient affiliated with Social Security.
For Grenoble and Toulouse Centers (Prandial algorithm test : MEAL):
- Patient is practicing functional insulin therapy is a fixed meal plan.
For CHSF center (test of algorithm during activity):
- Patient able to perform moderate or intense activity during 30 minutes.
Exclusion Criteria:
- Patients with type 2 diabetes
- All serious diseases that could interfere with the study
- Insulin resistance and obesity (BMI> 30 kg/m2 and / or insulin requirements> 2 U / kg / day)
学习计划
研究是如何设计的?
设计细节
- 主要用途:卫生服务研究
- 分配:非随机化
- 介入模型:交叉作业
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
---|---|
实验性的:Proposed treatment by Diabeloop algorithm
the insulin dose is calculated by the algorithm based on the usual treatment of the patient, the ratio I / C, the intensity of physical activity and blood glucose sensor.
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the intervention is applied only at the dose of insulin
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无干预:usual treatment
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研究衡量的是什么?
主要结果指标
结果测量 |
大体时间 |
---|---|
Time spent in glucose reference intervals
大体时间:After the end of the tests
|
After the end of the tests
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
---|---|---|
Measuring glucose sensor 2h, 3h and 4h post-prandial and AUC, in every situation tested to evaluate the efficacy and safety (time spent in hypoglycemia)
大体时间:After the end of the tests
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To evaluate the efficacy and safety of prandial algorithm, informed carbohydrate intake by the patient either quantitatively or semi-quantitative, or not informed way.
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After the end of the tests
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其他结果措施
结果测量 |
措施说明 |
大体时间 |
---|---|---|
Comparison of glucose sensor 2h, 3h and 4h post-prandial and AUC in conditions identical meals for each trigger level (50 or 75%). Measuring AUC during and 2 hours after physical activity, then to lunch time, during dinner and throughout the night.
大体时间:After the end of the tests
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|
After the end of the tests
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合作者和调查者
调查人员
- 学习椅:Guillaume CHARPENTIER, MD、Centre d'Etudes et de Recherche pour l'Intensification du Traitement du Diabète
- 首席研究员:Sylvia Franc, MD、Centre d'Etudes et de Recherche pour l'Intensification du Traitement du Diabète
- 首席研究员:Pierre-Yves BENHAMOU, Pr.、CHU of Grenoble
研究记录日期
研究主要日期
学习开始
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (估计)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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