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

2020年1月28日 更新者: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.

研究概览

详细说明

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.

研究类型

介入性

注册 (实际的)

15

阶段

  • 第一阶段早期

联系人和位置

本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。

学习地点

    • Connecticut
      • New Haven、Connecticut、美国、06520
        • Yale University School Of Medicine

参与标准

研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

18年 至 40年 (成人)

接受健康志愿者

有资格学习的性别

全部

描述

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

学习计划

本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。

研究是如何设计的?

设计细节

  • 主要用途:治疗
  • 分配:不适用
  • 介入模型:单组作业
  • 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: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.

由闭环单元和算法控制的胰岛素泵
Liraglutide is a long-acting analog of human glucagon like peptide-1 (GLP-1) that works as a GLP-1 receptor agonist
其他名称:
  • 维多沙

研究衡量的是什么?

主要结果指标

结果测量
措施说明
大体时间
Peak Post-prandial Venous Glucose Levels
大体时间:48 hours
peak post-prandial venous glucose levels obtained after breakfast, lunch, and dinner between closed loop (CL) alone and CL + liraglutide
48 hours

次要结果测量

结果测量
大体时间
the Incremental Meal-related Glucose Area Under Curve (AUC)
大体时间:5-hour post prandial period after breakfast, lunch, and dinner
5-hour post prandial period after breakfast, lunch, and dinner

其他结果措施

结果测量
大体时间
Mean 24-hour Glucose Levels
大体时间:24- hours
24- hours
Mean Time to Peak Post-meal Glucose Value
大体时间:5- hour postprandial period
5- hour postprandial period
Mean Daytime Glucose Levels
大体时间:8a.m.-11p.m.
8a.m.-11p.m.
Incremental Glucagon Peak
大体时间:5 hours
5 hours
AUC Plasma Glucagon During MMTT
大体时间:2 hours
2 hours
Differences in Daily Insulin Requirements
大体时间:24 hours
24 hours
Prandial Insulin Delivery During Closed Loop Therapy
大体时间: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
大体时间:11p.m.-6a.m.
11p.m.-6a.m.

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

调查人员

  • 首席研究员:Jennifer Sherr, MD, PhD、Yale University

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始

2013年2月1日

初级完成 (实际的)

2015年11月1日

研究完成 (实际的)

2015年11月1日

研究注册日期

首次提交

2013年5月14日

首先提交符合 QC 标准的

2013年5月14日

首次发布 (估计)

2013年5月17日

研究记录更新

最后更新发布 (实际的)

2020年1月30日

上次提交的符合 QC 标准的更新

2020年1月28日

最后验证

2020年1月1日

更多信息

此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.

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